Provider Demographics
NPI:1467556159
Name:MELENDEZ RIOS, EDWIN (MD)
Entity Type:Individual
Prefix:
First Name:EDWIN
Middle Name:
Last Name:MELENDEZ RIOS
Suffix:
Gender:M
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:P O BOX 1908
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00970
Mailing Address - Country:US
Mailing Address - Phone:787-793-2462
Mailing Address - Fax:787-774-1615
Practice Address - Street 1:HOSPITAL METROPOLITANO CARR 21
Practice Address - Street 2:OFICINA 203
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-793-2462
Practice Address - Fax:787-774-1615
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6744207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR068393OtherCRUZ AZUL
PR98418MEOtherTRIPLE S
PR2513OtherINTERNATIONAL MEDICAL CAR
PRD08768Medicare UPIN
PR92418Medicare ID - Type UnspecifiedMEDICARE