Provider Demographics
NPI:1891436168
Name:MELO BERNARD, ALEXANDRA CARLA (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:CARLA
Last Name:MELO BERNARD
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 1:1508 N HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-3813
Mailing Address - Country:US
Mailing Address - Phone:301-538-4878
Mailing Address - Fax:
Practice Address - Street 1:6431 FANNIN ST # MSB3.151
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:301-538-4878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-02
Last Update Date:2022-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program