Provider Demographics
NPI:1811586332
Name:MELENDEZ, KARENI MICHELLE (SLP)
Entity Type:Individual
Prefix:
First Name:KARENI
Middle Name:MICHELLE
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 CALLE LOS ANDES
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-0561
Mailing Address - Country:US
Mailing Address - Phone:787-469-6227
Mailing Address - Fax:
Practice Address - Street 1:172 CALLE LOS ANDES
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-0561
Practice Address - Country:US
Practice Address - Phone:787-469-6227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4308235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR6119216OtherDRIVER'S LICENSE
PR6396103OtherELECTORAR CARD