Provider Demographics
NPI:1255323093
Name:MELHADO, MAURICIO (MD)
Entity Type:Individual
Prefix:DR
First Name:MAURICIO
Middle Name:
Last Name:MELHADO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3472 FOREST HILL BLVD
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33406-5864
Mailing Address - Country:US
Mailing Address - Phone:561-619-3051
Mailing Address - Fax:561-619-3055
Practice Address - Street 1:3472 FOREST HILL BLVD
Practice Address - Street 2:SUITE 3B
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33406-5864
Practice Address - Country:US
Practice Address - Phone:561-619-3051
Practice Address - Fax:561-619-3055
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89191207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270147200Medicaid
H78321Medicare UPIN
H78321Medicare UPIN