Provider Demographics
NPI:1447583174
Name:RODRIGUEZ - MELENDEZ, IRMA DENNISE (MD)
Entity Type:Individual
Prefix:DR
First Name:IRMA
Middle Name:DENNISE
Last Name:RODRIGUEZ - MELENDEZ
Suffix:
Gender:F
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:HC 1 BOX 3594
Mailing Address - Street 2:CARR. 143 KM 43.1
Mailing Address - City:VILLALBA
Mailing Address - State:PR
Mailing Address - Zip Code:00766-9790
Mailing Address - Country:US
Mailing Address - Phone:787-242-5339
Mailing Address - Fax:
Practice Address - Street 1:HC 1 BOX 3594
Practice Address - Street 2:CARR. 143 KM 43.1
Practice Address - City:VILLALBA
Practice Address - State:PR
Practice Address - Zip Code:00766-9790
Practice Address - Country:US
Practice Address - Phone:787-242-5339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17706208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice