Provider Demographics
NPI:1700814084
Name:MELENDEZ MALDONADO, JOSE E (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:E
Last Name:MELENDEZ MALDONADO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:100 ROSEVILLE DR
Mailing Address - Street 2:APT 22
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-9645
Mailing Address - Country:US
Mailing Address - Phone:787-448-0747
Mailing Address - Fax:787-744-5433
Practice Address - Street 1:201 CALLE GAUTIER BENITEZ
Practice Address - Street 2:CONSOLIDATED MEDICAL PLAZA, SUITE 101
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5527
Practice Address - Country:US
Practice Address - Phone:787-744-5278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2010-07-18
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Provider Licenses
StateLicense IDTaxonomies
PR14048207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH65137Medicare UPIN