Provider Demographics
NPI:1265172803
Name:MELECIO-ZAMBRANO, LUISELY (CPM, LDEM)
Entity type:Individual
Prefix:
First Name:LUISELY
Middle Name:
Last Name:MELECIO-ZAMBRANO
Suffix:
Gender:F
Credentials:CPM, LDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5709 43RD AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20781-1605
Mailing Address - Country:US
Mailing Address - Phone:850-737-1333
Mailing Address - Fax:
Practice Address - Street 1:7301 GARLAND AVE
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6417
Practice Address - Country:US
Practice Address - Phone:301-674-9976
Practice Address - Fax:855-282-0727
Is Sole Proprietor?:No
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDEM00037176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife