Provider Demographics
NPI:1154547156
Name:MELENDEZ, LIGIA M
Entity type:Individual
Prefix:MRS
First Name:LIGIA
Middle Name:M
Last Name:MELENDEZ
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:AS6 CALLE 17
Mailing Address - Street 2:URBANIZACION PRADERAS
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-4084
Mailing Address - Country:US
Mailing Address - Phone:787-646-2630
Mailing Address - Fax:787-763-5312
Practice Address - Street 1:URB EL VEDADO COND EL CENTRO SUITE 15
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-763-5308
Practice Address - Fax:787-763-5312
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR003040OtherPHARMACIST LICENSE