Provider Demographics
NPI:1477702546
Name:FELICIANO-MELENDEZ, AUDBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:AUDBERTO
Middle Name:
Last Name:FELICIANO-MELENDEZ
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 1:383 CEDRO ST
Mailing Address - Street 2:URB. FAJARDO GARDENS
Mailing Address - City:FAJARDO
Mailing Address - State:PR
Mailing Address - Zip Code:00738-2953
Mailing Address - Country:US
Mailing Address - Phone:787-988-8641
Mailing Address - Fax:
Practice Address - Street 1:AVE. LAUREL
Practice Address - Street 2:BAYAMON GARDENS
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00960-6032
Practice Address - Country:US
Practice Address - Phone:787-988-8641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27217-R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine