Provider Demographics
NPI:1992144281
Name:MENDEZ, JAROLD (MD)
Entity type:Individual
Prefix:
First Name:JAROLD
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6255 W SUNSET BLVD FL 21
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7422
Mailing Address - Country:US
Mailing Address - Phone:323-860-5200
Mailing Address - Fax:323-467-7119
Practice Address - Street 1:PASEO DEL PRADO SHOPPING CENTER PR-3 KM 8.4
Practice Address - Street 2:SUITE 107
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987-0098
Practice Address - Country:US
Practice Address - Phone:787-300-3188
Practice Address - Fax:873-003-4327
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR21137207P00000X, 208D00000X, 207RI0200X
FLME164076207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice