1770885352 NPI number — DR SAMUEL MELENDEZ INTERNAL MEDICINE SERVICES PSC

Table of content: MRS. LOIS REGAN NAET, CNHP, EDST (NPI 1740991892)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770885352 NPI number — DR SAMUEL MELENDEZ INTERNAL MEDICINE SERVICES PSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR SAMUEL MELENDEZ INTERNAL MEDICINE SERVICES PSC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1770885352
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 250
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00681-0250
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-831-3845
Provider Business Mailing Address Fax Number:
787-831-3845

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 2
Provider Second Line Business Practice Location Address:
AVE. HOSTOS 770 SUITE 205
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00682-6353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-831-3845
Provider Business Practice Location Address Fax Number:
787-831-3845
Provider Enumeration Date:
12/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
MELENDEZ
Authorized Official First Name:
SAMUEL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-831-3845

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  10288 , 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)





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