Provider Demographics
NPI:1780259127
Name:MELENDEZ, DENISE YVETTE
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:YVETTE
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DENISE
Other - Middle Name:YVETTE
Other - Last Name:MELENDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ELITE BILLING LLC
Mailing Address - Street 1:11 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-6430
Mailing Address - Country:US
Mailing Address - Phone:954-857-8479
Mailing Address - Fax:954-246-0993
Practice Address - Street 1:11 PALM AVE
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-6430
Practice Address - Country:US
Practice Address - Phone:954-857-8479
Practice Address - Fax:954-246-0993
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDMMHC2021174400000X, 174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDMMHC2021OtherCHURCH