Provider Demographics
NPI:1922823889
Name:MELENDEZ, LYNETT (MD)
Entity type:Individual
Prefix:
First Name:LYNETT
Middle Name:
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LYNETT
Other - Middle Name:
Other - Last Name:CASTANEDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:306 BANGOR WAY
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34758-2734
Mailing Address - Country:US
Mailing Address - Phone:786-942-0084
Mailing Address - Fax:
Practice Address - Street 1:306 BANGOR WAY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34758-2734
Practice Address - Country:US
Practice Address - Phone:786-942-0084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-16
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty