Angie Veronica Heredia Mendez, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

17853-I Issued in PR

Practice address

Jesus T. Pineiro Building, Section 8
Carolina, PR 00986

Phone

(347) 793-2806

NPI assigned

Apr 5, 2022

Reactivated

Aug 13, 2026

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1205577145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 CALLE TORREMOLINO",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "009855108",
            "telephone_number": "347-793-2806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JESUS T. PINEIRO BUILDING, SECTION 8",
            "city": "CAROLINA",
            "state": "PR",
            "postal_code": "00986",
            "telephone_number": "347-793-2806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEREDIA MENDEZ",
        "first_name": "ANGIE",
        "middle_name": "VERONICA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "deactivation_date": "2024-05-03",
        "reactivation_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "17853-I",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in Carolina, PR
• Providers in Carolina, PR by specialty
• Student in an Organized Health Care Education/Training Program in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.