Provider Demographics
NPI:1487629606
Name:MELENDEZ-DEDOS, ANDRES (MD)
Entity Type:Individual
Prefix:
First Name:ANDRES
Middle Name:
Last Name:MELENDEZ-DEDOS
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:PO BOX 367228
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-7228
Mailing Address - Country:US
Mailing Address - Phone:787-754-6258
Mailing Address - Fax:787-250-9599
Practice Address - Street 1:369 AVE DE DIEGO
Practice Address - Street 2:TORRE HOSPITAL SAN FRANCISCO SUITE 303
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-3003
Practice Address - Country:US
Practice Address - Phone:787-763-9005
Practice Address - Fax:787-250-7517
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11834207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine