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General NPI Number Information
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NPI Number | 1891126744
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Entity Type | Individual
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Provider Name | SAMUEL VELORIA MENDOZA PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/03/2013
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Last Update Date | 12/03/2013
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Provider Practice Location Address
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Address Line | USNH GUANTANAMO BAY BOX 161
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City | FPO
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State | AE
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Zip | 09589-9997
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Country | US
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Telephone | 01153992360
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Fax |
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Provider Business Mailing Address
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Address Line | USNH GUANTANAMO BAY BOX 161
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City | FPO
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State | AE
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Zip | 09589-9997
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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 |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 70095
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License Number State | CA
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