Provider Demographics
NPI:1598020042
Name:MELENDEZ, JOSE ENRIQUE (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:ENRIQUE
Last Name:MELENDEZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:TERRAZAS PARQUE ESCORIAL 605 BLV MEDIA LUNA
Mailing Address - Street 2:APT #6105
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982
Mailing Address - Country:US
Mailing Address - Phone:787-309-8154
Mailing Address - Fax:787-999-7205
Practice Address - Street 1:TERRAZAS DE PARQUE ESCORIAL 605 MEDIA LUNA #6105
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00924-1111
Practice Address - Country:US
Practice Address - Phone:787-309-8154
Practice Address - Fax:787-999-7205
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist