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General NPI Number Information
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NPI Number | 1194351940
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Entity Type | Individual
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Provider Name | DEBORAH MENDEZ GINES MD
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Gender | Female
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Dates
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Enumeration Date | 03/12/2020
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Last Update Date | 10/21/2023
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Provider Practice Location Address
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Address Line | 2016 AVE BORINQUEN
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City | SAN JUAN
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State | PR
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Zip | 00915-3823
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Country | US
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Telephone | 787-405-7073
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Fax |
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Provider Business Mailing Address
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Address Line | 314 CALLE ANA CASTELAR
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City | SAN JUAN
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State | PR
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Zip | 00912-3513
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Country | US
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Telephone | 787-405-7073
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 23463
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License Number State | PR
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