Provider Demographics
NPI:1831443704
Name:MELENDEZ, HECTOR RAFAEL (MA)
Entity type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:RAFAEL
Last Name:MELENDEZ
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A11 URB SAN MIGUEL
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-2540
Mailing Address - Country:US
Mailing Address - Phone:787-685-0078
Mailing Address - Fax:
Practice Address - Street 1:A11 URB SAN MIGUEL
Practice Address - Street 2:
Practice Address - City:SANTA ISABEL
Practice Address - State:PR
Practice Address - Zip Code:00757-2540
Practice Address - Country:US
Practice Address - Phone:787-685-0078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-31
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4146103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling