Provider Demographics
NPI:1124282389
Name:MELENDEZ, ANGELICA MARIA
Entity type:Individual
Prefix:MRS
First Name:ANGELICA
Middle Name:MARIA
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COND. DE DIEGO CHALETS 474 CALLE DE DIEGO
Mailing Address - Street 2:APTO. 21
Mailing Address - City:SAN JUAN
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00923
Mailing Address - Country:UM
Mailing Address - Phone:787-486-5375
Mailing Address - Fax:
Practice Address - Street 1:COND. DE DIEGO CHALETS 474 CALLE DE DIEGO
Practice Address - Street 2:APTO. 21
Practice Address - City:SAN JUAN
Practice Address - State:PUERTO RICO
Practice Address - Zip Code:00923
Practice Address - Country:UM
Practice Address - Phone:787-486-5375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR831235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist