Individual
RYAN DERRICK MENDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5804 BURT RD APT A, COLUMBIA, SC 29206-6317
(786) 379-9502
Mailing address
5804 BURT RD APT A, COLUMBIA, SC 29206-6317
(786) 379-9502
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
M532-724-95-413-0
SC
Other
Enumeration date
11/26/2025
Last updated
11/26/2025
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