Provider Demographics
NPI:1891047742
Name:ALFREDO MELGAR, MD PA
Entity Type:Organization
Organization Name:ALFREDO MELGAR, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MELGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-223-2436
Mailing Address - Street 1:8275 SW 93RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7358
Mailing Address - Country:US
Mailing Address - Phone:305-401-5596
Mailing Address - Fax:305-223-2438
Practice Address - Street 1:10000 SW 56TH ST STE 17
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7162
Practice Address - Country:US
Practice Address - Phone:305-223-2436
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1027962207R00000X
208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006636500Medicaid