Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 19313 | PR |
N | 207NP0225X | Pediatric Dermatologist | 19313 | PR |
N | 207NS0135X | Procedural Dermatology | 19313 | PR |
NPI | 1174817449 |
---|---|
Provider Name | Dr. Amilcar Gabriel Rodriguez Melendez |
First Address | Ponce, PR 00717-1320 |
Second Address | Ponce, PR 00717-1320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2011 |
Last Update Date | 22/12/2016 |