Provider Demographics
NPI: | 1942403845 |
---|---|
Name: | MELENDEZ-ROMERO, IVETTE |
Entity Type: | Individual |
Prefix: | MRS |
First Name: | IVETTE |
Middle Name: | |
Last Name: | MELENDEZ-ROMERO |
Suffix: | |
Gender: | F |
Credentials: | |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 2254 NW 41ST PL |
Mailing Address - Street 2: | |
Mailing Address - City: | GAINESVILLE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32605-1756 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 352-256-8377 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1601 SW ARCHER RD |
Practice Address - Street 2: | |
Practice Address - City: | GAINESVILLE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32608-1135 |
Practice Address - Country: | US |
Practice Address - Phone: | 352-376-1611 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2007-06-07 |
Last Update Date: | 2007-07-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PR | 2820 | 246QM0706X, 246QC1000X, 246QH0000X, 246QB0000X, 246QI0000X, 246QM0900X, 246RP1900X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Not Answered | 246QM0706X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Pathology | Medical Technologist |
Not Answered | 246QC1000X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Pathology | Chemistry |
Not Answered | 246QH0000X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Pathology | Hematology |
Not Answered | 246QB0000X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Pathology | Blood Banking |
Not Answered | 246QI0000X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Pathology | Immunology |
Not Answered | 246QM0900X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Pathology | Microbiology |
Not Answered | 246RP1900X | Technologists, Technicians & Other Technical Service Providers | Technician, Pathology | Phlebotomy |