Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 10501 | PR |
N | 207Q00000X | Family Doctor | 10501 | PR |
NPI | 1356404909 |
---|---|
Provider Name | Dr. Felix Melendez Ortiz |
First Address | San Juan, PR 00928 |
Second Address | Carolina, PR 00982 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500042E | MMM (01) | PR |
82900 | SSS (01) | PR |
F47600 | (02) |