Provider Demographics
NPI:1649381856
Name:MELENDEZ-MARTINEZ, OLGA (MD)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:MELENDEZ-MARTINEZ
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:PO BOX 9097
Mailing Address - Street 2:PLAZA CAROLINA MALL
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00988-9097
Mailing Address - Country:US
Mailing Address - Phone:787-923-3246
Mailing Address - Fax:787-754-7529
Practice Address - Street 1:HOSPITAL RYDER
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-923-3246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7167207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
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9280005OtherHUMAN HEALTH INSURANCE
29495OtherTRIPLE S
C82247Medicare UPIN