Provider Demographics
NPI:1831182690
Name:MELENDEZ COLLAZO, AURORA (MD)
Entity type:Individual
Prefix:DR
First Name:AURORA
Middle Name:
Last Name:MELENDEZ COLLAZO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 591
Mailing Address - Street 2:
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778-0591
Mailing Address - Country:US
Mailing Address - Phone:787-737-3936
Mailing Address - Fax:
Practice Address - Street 1:EUGENIO SANCHEZ LOPEZ URB. LOS MAESTROS
Practice Address - Street 2:A-16
Practice Address - City:GURABO
Practice Address - State:PR
Practice Address - Zip Code:00778
Practice Address - Country:US
Practice Address - Phone:787-737-3936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4787207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0025825Medicare PIN