Provider Demographics
NPI:1205077021
Name:ALCARAZ, MELQUIADES
Entity type:Individual
Prefix:
First Name:MELQUIADES
Middle Name:
Last Name:ALCARAZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12890 SW 28TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-3835
Mailing Address - Country:US
Mailing Address - Phone:954-431-9871
Mailing Address - Fax:
Practice Address - Street 1:12890 SW 28TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-3835
Practice Address - Country:US
Practice Address - Phone:954-431-9871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9193106163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine