Provider Demographics
NPI:1144879768
Name:MENDEZ GOMEZ, DANNY JOSUE (DC)
Entity type:Individual
Prefix:DR
First Name:DANNY
Middle Name:JOSUE
Last Name:MENDEZ GOMEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND COSTA BRAVA
Mailing Address - Street 2:APT 2-302
Mailing Address - City:CEIBA
Mailing Address - State:PR
Mailing Address - Zip Code:00735
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CENTRO QUIROPRACTICO DE PUERTO RICO
Practice Address - Street 2:FAJARDO MARKET SQUARE, CARR 3 KM 45.4
Practice Address - City:FAJARDO
Practice Address - State:PR
Practice Address - Zip Code:00738
Practice Address - Country:US
Practice Address - Phone:939-276-7979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR702111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor