Healthcare Provider Details

I. General information

NPI: 1336690783
Provider Name (Legal Business Name): VICTOR MENENDEZ-BRUNO SR. HEALTH EDUCATOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2016
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 AVE CHARDON 500 TORRE CHARDON
SAN JUAN PR
00918-2124
US

IV. Provider business mailing address

50 VEREDA LOS LAURELES COND CAMINOS DEL BOSQUE
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-622-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: