Provider Demographics
NPI:1487992103
Name:MELENDEZ, MERCEDES
Entity type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE D BLOQUE O NUM. 17
Mailing Address - Street 2:EXTENSION GUARICO
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693
Mailing Address - Country:US
Mailing Address - Phone:787-209-0714
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA PRINCIAPL 149
Practice Address - Street 2:PRYMED CIALES
Practice Address - City:CIALES
Practice Address - State:PR
Practice Address - Zip Code:00638-0000
Practice Address - Country:US
Practice Address - Phone:787-871-0601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3067246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other