Provider Demographics
NPI:1891761896
Name:MELENDEZ ORTIZ, ELIUT (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIUT
Middle Name:
Last Name:MELENDEZ ORTIZ
Suffix:
Gender:M
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 362186
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-2186
Mailing Address - Country:US
Mailing Address - Phone:787-282-3000
Mailing Address - Fax:787-767-2272
Practice Address - Street 1:369 CALLE DE DIEGO
Practice Address - Street 2:TORRE SAN FRANCISCO, SUITE 509
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00923-3003
Practice Address - Country:US
Practice Address - Phone:787-282-3000
Practice Address - Fax:787-767-2272
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10154207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR991841OtherMMM
PR82936OtherTRIPLE-S
PR9250091OtherHUMANA
PR2724OtherPREFERRED MEDICARE CHOICE
PR210154OtherMCS
PR9250091OtherHUMANA
PRF30910Medicare UPIN