Provider Demographics
NPI:1821496126
Name:CDT DR MELENDEZ, INC
Entity Type:Organization
Organization Name:CDT DR MELENDEZ, INC
Other - Org Name:CENTRO RADIOLOGICO CDT DR MELENDEZ
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:MELENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-854-6999
Mailing Address - Street 1:PO BOX 1019
Mailing Address - Street 2:
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-1019
Mailing Address - Country:US
Mailing Address - Phone:787-854-6999
Mailing Address - Fax:787-854-6999
Practice Address - Street 1:CARR 685 KM 1.9
Practice Address - Street 2:BO. TIERRAS NUEVAS
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674
Practice Address - Country:US
Practice Address - Phone:787-854-6999
Practice Address - Fax:787-854-6999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR44261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology