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General NPI Number Information
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NPI Number | 1063824449
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Entity Type | Organization
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Legal Business Name | DR. DOMINGO MENDEZ MENDEZ CSP
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Dates
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Enumeration Date | 05/20/2014
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Last Update Date | 05/20/2014
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Provider Practice Location Address
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Address Line | B 11 CALLE 2 URB. VILLA REAL
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-413-4035
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 857
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City | MANATI
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State | PR
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Zip | 00674-0857
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. DOMINGO MENDEZ
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Credential |
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Telephone | 787-413-4035
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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