Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | D0059223 | MD |
N | 207RI0200X | Infectious Disease | 25MA07398100 | NJ |
N | 207RI0200X | Infectious Disease | D0059223 | MD |
Y | 207RI0200X | Infectious Disease | ME122301 | FL |
NPI | 1013975366 |
---|---|
Provider Name | Melchor Madarang |
First Address | The Villages, FL 32159-6827 |
Second Address | The Villages, FL 32159-6827 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 19/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0105392 | (05) | NJ |
014115300 | (05) | FL |
400080300 | (05) | MD |
H72381 | (02) | MD |
IB137Z | MEDICARE PTAN (01) | FL |