Provider Demographics
NPI:1942007141
Name:MENDEZ RIOS, JATNAEL
Entity type:Individual
Prefix:MR
First Name:JATNAEL
Middle Name:
Last Name:MENDEZ RIOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 52 BOX 2082
Mailing Address - Street 2:
Mailing Address - City:GARROCHALES
Mailing Address - State:PR
Mailing Address - Zip Code:00652-9108
Mailing Address - Country:US
Mailing Address - Phone:939-777-5548
Mailing Address - Fax:
Practice Address - Street 1:HC 52 BOX 2082
Practice Address - Street 2:
Practice Address - City:GARROCHALES
Practice Address - State:PR
Practice Address - Zip Code:00652-9108
Practice Address - Country:US
Practice Address - Phone:939-777-5548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6018447390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program