1316041775 NPI number — MR. EMILIO ENCARNACION - MELENDEZ MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316041775 NPI number — MR. EMILIO ENCARNACION - MELENDEZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ENCARNACION - MELENDEZ
Provider First Name:
EMILIO
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316041775
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/16/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 GRAND BLVD LOS PRADOS
Provider Second Line Business Mailing Address:
COND. SERENA APARTADO 29203
Provider Business Mailing Address City Name:
CAGUAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00727
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-593-1815
Provider Business Mailing Address Fax Number:
787-286-6161

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PLAZA DEL CARMEN #24
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAGUAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-286-6060
Provider Business Practice Location Address Fax Number:
787-286-6161
Provider Enumeration Date:
09/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  13963 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 11913963 . This is a "GLOBAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 21914 . This is a "SSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7450057 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 201796 . This is a "UTI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3678 . This is a "PREFRED MEDICAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: S00227E . This is a "MMM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3025 . This is a "AMERICAN H" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9285 . This is a "IMC" identifier . This identifiers is of the category "OTHER".




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