Provider Demographics
NPI:1154404044
Name:MENDEZ MARTIR, ISABEL (OD)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:MENDEZ MARTIR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ISABEL
Other - Middle Name:
Other - Last Name:MENDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:CALLE HORTENSIA #1176
Mailing Address - Street 2:URB MANSIONES DE RIO PIEDRAS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-307-8394
Mailing Address - Fax:
Practice Address - Street 1:RIO HONDO MALL LOCAL 33B
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960
Practice Address - Country:US
Practice Address - Phone:787-261-5547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR503152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist