Provider Demographics
NPI:1437243508
Name:MELENDEZ, JUDITH
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 CALLE MONTE ATENAS CONDO
Mailing Address - Street 2:SUITE 1007
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-241-7881
Mailing Address - Fax:787-723-1736
Practice Address - Street 1:305 TORRE DEL METROPOLITANO
Practice Address - Street 2:LAS LOMAS RIO PIEDRAS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-241-7881
Practice Address - Fax:787-723-1736
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16531207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine