Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 17438 | PR |
NPI | 1013157726 |
---|---|
Provider Name | Dr. Luz S Melendez Gomez |
First Address | Arroyo, PR 00714 |
Second Address | Arroyo, PR 00714-2025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2009 |
Last Update Date | 16/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17438 | PUERTO RICO LICENSE (01) | PR |