Provider Demographics
NPI:1316041775
Name:ENCARNACION - MELENDEZ, EMILIO (MD)
Entity Type:Individual
Prefix:MR
First Name:EMILIO
Middle Name:
Last Name:ENCARNACION - MELENDEZ
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 1:500 GRAND BLVD LOS PRADOS
Mailing Address - Street 2:COND. SERENA APARTADO 29203
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:787-593-1815
Mailing Address - Fax:787-286-6161
Practice Address - Street 1:PLAZA DEL CARMEN #24
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-286-6060
Practice Address - Fax:787-286-6161
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13963208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
11913963OtherGLOBAL HEALTH
21914OtherSSS
7450057OtherHUMANA
201796OtherUTI
3678OtherPREFRED MEDICAL
S00227EOtherMMM
3025OtherAMERICAN H
9285OtherIMC
21914OtherSSS
H95795Medicare UPIN