Provider Demographics
NPI:1316557739
Name:MARFULL-MELENDEZ, ALVARO DAMIAN
Entity Type:Individual
Prefix:
First Name:ALVARO
Middle Name:DAMIAN
Last Name:MARFULL-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 1:6612 CROW CIR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-2001
Mailing Address - Country:US
Mailing Address - Phone:405-423-5129
Mailing Address - Fax:
Practice Address - Street 1:6612 CROW CIR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-2001
Practice Address - Country:US
Practice Address - Phone:405-423-5129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-01
Last Update Date:2020-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator