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General NPI Number Information
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NPI Number | 1942249503
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Entity Type | Individual
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Provider Name | ROBERTO MENDEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2431 AVE LAS AMERICAS SUITE 206
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City | PONCE
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State | PR
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Zip | 00717-2113
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Country | US
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Telephone | 787-842-9345
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Fax | 787-841-5872
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Provider Business Mailing Address
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Address Line | 2431 AVE LAS AMERICAS SUITE 206
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City | PONCE
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State | PR
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Zip | 00717-2113
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Country | US
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Telephone | 787-842-9345
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Fax | 787-841-5872
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | ME125458
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 12515
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License Number State | PR
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