Healthcare Provider Details

I. General information

NPI: 1619275609
Provider Name (Legal Business Name): DRA CELIA G MENDEZ, OBGYN, CSP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PARQ CENTRAL SUITE 3 568 JUAN J JIMENEZ
SAN JUAN PR
00918-2676
US

IV. Provider business mailing address

URB MANSIONES DE RIO PIEDRAS 1174 HORTENSIA
SAN JUAN PR
00926-1174
US

V. Phone/Fax

Practice location:
  • Phone: 787-753-0424
  • Fax: 787-753-0545
Mailing address:
  • Phone: 787-753-0424
  • Fax: 787-753-0545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number StatePR

VIII. Authorized Official

Name: DR. CELIA G MENDEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-753-0424