Indira E Matute Mendoza, 17,668-I

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

17668-I Issued in PR

Practice address

355 Ave Font, Martelo
Shopping Court, 2ND Floor
Humacao, PR 00791

Phone

(787) 200-7833

NPI assigned

Jul 3, 2024

Last updated

Jan 23, 2026By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1719964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1336985886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13072",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009083072",
            "telephone_number": "787-631-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 AVE FONT, MARTELO",
            "address_2": "SHOPPING COURT, 2ND FLOOR",
            "city": "HUMACAO",
            "state": "PR",
            "postal_code": "00791",
            "telephone_number": "787-200-7833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATUTE MENDOZA",
        "first_name": "INDIRA",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "17,668-I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-03",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "17668-I",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pedro Concepcion Martinez
• Rut Noemi Martinez, PHARMACY TECHNICIAN
• Sandra Martinez, RPHA
• Mas Salud IV LLC
• Miguel A Matta Rivera, MD
• Hector Rafael Maymi, M.D.
• MB Clinical Laboratories Corp.
• MB Clinical Laboratories Corp. (Laboratorio Clinico Villa Ana Humacao)
• Mci Land Corporation (Laboratorio Clinico Pitahaya)
• Med-Ai

• General Practice Physician in Humacao, PR
• Providers in Humacao, PR by specialty
• General Practice Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.