Provider Demographics
NPI:1114481892
Name:DURAN MELENDEZ, OSVALDO EMMANUEL
Entity Type:Individual
Prefix:
First Name:OSVALDO
Middle Name:EMMANUEL
Last Name:DURAN MELENDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29207
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0207
Mailing Address - Country:US
Mailing Address - Phone:787-757-1800
Mailing Address - Fax:
Practice Address - Street 1:CARR 3 KM. 8.3 AVE 65 DE INFANTERIA
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00984
Practice Address - Country:US
Practice Address - Phone:787-757-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-26
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME166747207P00000X
PR36428207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine