MEDICARE: EMERITA E MENDEZ RIOS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	005495	PR

General Provider Information

NPI Number	:	1487064739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMERITA E MENDEZ RIOS

Provider Business Mailing Address
First Line	:	HC-04 BOX 47199
Second Line	:
City	:	CAGUAS
State	:	PR
Zip	:	00725
Country	:	US
Telephone Number	:	787-448-3303
Fax Number	:

Provider Business Practice Location Address
First Line	:	1007 AVE MUNOZ RIVERA SUITE 402
Second Line	:	EDIFICIO DARLINGTON
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00925
Country	:	US
Telephone Number	:	787-448-3303
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2014
Last Update Date	:	08/18/2017

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Directions to “ EMERITA E MENDEZ RIOS ” Practice Location

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