Provider Demographics
NPI:1396079265
Name:MENDRELL, GLORIA L
Entity type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:L
Last Name:MENDRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 605703
Mailing Address - Street 2:PMB 103
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-9002
Mailing Address - Country:US
Mailing Address - Phone:787-410-1537
Mailing Address - Fax:787-891-1450
Practice Address - Street 1:BO. PIEDRAS BLANCAS
Practice Address - Street 2:SECTOR LA MINA 103
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602
Practice Address - Country:US
Practice Address - Phone:787-410-1537
Practice Address - Fax:787-891-1450
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-25
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management