Provider Demographics
NPI:1124196290
Name:MELENDEZ, MARIBEL (MS)
Entity Type:Individual
Prefix:MS
First Name:MARIBEL
Middle Name:
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:MS
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 192075
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-2075
Mailing Address - Country:US
Mailing Address - Phone:787-282-0973
Mailing Address - Fax:787-753-7496
Practice Address - Street 1:652 AVE MUNOZ RIVERA STE 2050
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-4295
Practice Address - Country:US
Practice Address - Phone:787-754-6359
Practice Address - Fax:787-753-7496
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2008-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR518231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist