MEDICARE: JAROLD MENDEZ MD

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	207P00000X	Emergency Medicine Physician	21137	PR
2	207RI0200X	Infectious Disease Physician	ME164076	FL
3	208D00000X	General Practice Physician	21137	PR
4	207RI0200X	Infectious Disease Physician	21137	PR

General Provider Information

NPI Number	:	1992144281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAROLD MENDEZ MD

Provider Business Mailing Address
First Line	:	6255 W SUNSET BLVD FL 21
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-7422
Country	:	US
Telephone Number	:	323-860-5200
Fax Number	:	323-467-7119

Provider Business Practice Location Address
First Line	:	PASEO DEL PRADO SHOPPING CENTER PR-3 KM 8.4
Second Line	:	SUITE 107
City	:	CAROLINA
State	:	PR
Zip	:	00987-0098
Country	:	US
Telephone Number	:	787-300-3188
Fax Number	:	873-003-4327

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

Provider Enumeration Date	:	06/19/2013
Last Update Date	:	05/06/2024

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