Provider Demographics
NPI:1326688482
Name:MELENDEZ CORA, LIANNE STEPHANIE (PHARMD)
Entity Type:Individual
Prefix:
First Name:LIANNE
Middle Name:STEPHANIE
Last Name:MELENDEZ CORA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB ARROYO DEL MAR CALLE CARIBE
Mailing Address - Street 2:#108
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CALLE DERKES
Practice Address - Street 2:#28
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-864-2112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist