MEDICARE: DR. FELIX MENDOZA ROSA M.D.

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	208800000X	Urology Physician	9021	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0081551	OTHER	PR	PTAN

General Provider Information

NPI Number	:	1558339515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FELIX MENDOZA ROSA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 372918
Second Line	:
City	:	CAYEY
State	:	PR
Zip	:	00737-2918
Country	:	US
Telephone Number	:	787-263-3131
Fax Number	:	787-738-8457

Provider Business Practice Location Address
First Line	:	22 HERACLIO MENDOZA ST.
Second Line	:
City	:	CAYEY
State	:	PR
Zip	:	00736-0000
Country	:	US
Telephone Number	:	787-263-3131
Fax Number	:	787-738-8457

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	12/05/2012

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