Provider Demographics
NPI:1528582798
Name:MELGAREJO, CARLOS E
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:MELGAREJO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3467 SOMERSET PARK DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-7342
Mailing Address - Country:US
Mailing Address - Phone:407-393-8971
Mailing Address - Fax:
Practice Address - Street 1:3467 SOMERSET PARK DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32824
Practice Address - Country:US
Practice Address - Phone:407-393-8971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator