Provider Demographics
NPI:1356813430
Name:FIGUEROA, MELISSA IVETTE (RD)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:IVETTE
Last Name:FIGUEROA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7530 OMNI LN APT 107
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33905-5471
Mailing Address - Country:US
Mailing Address - Phone:787-435-5368
Mailing Address - Fax:
Practice Address - Street 1:HACIENDA PALOMA #19
Practice Address - Street 2:CALLE ARAUCANA
Practice Address - City:LUQUILLO
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00773
Practice Address - Country:UM
Practice Address - Phone:787-435-5368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-29
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9131133V00000X
PR002080133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered