Provider Demographics
NPI:1811443104
Name:MELENDEZ, YOSANNA
Entity type:Individual
Prefix:
First Name:YOSANNA
Middle Name:
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 1:4408 KENDAL CT
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596
Mailing Address - Country:US
Mailing Address - Phone:401-499-2921
Mailing Address - Fax:
Practice Address - Street 1:4408 KENDAL CT
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596
Practice Address - Country:US
Practice Address - Phone:401-499-2921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-28
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services