Individual
JUAN CARLOS HEREDIA MENDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
C17 CALLE MARGINAL, BAYAMON, PR 00961-6706
(787) 523-3113
Mailing address
446 CALLE 4, SAN JUAN, PR 00926-1924
(787) 310-3071
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
307-P.A.
PR
Other
Enumeration date
09/21/2020
Last updated
09/21/2020
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