Provider Demographics
NPI:1861411993
Name:MELO, JULIO C (MD)
Entity type:Individual
Prefix:DR
First Name:JULIO
Middle Name:C
Last Name:MELO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 E GRAY ST
Mailing Address - Street 2:652
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1901
Mailing Address - Country:US
Mailing Address - Phone:502-587-9478
Mailing Address - Fax:502-589-4267
Practice Address - Street 1:234 E GRAY ST
Practice Address - Street 2:652
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1901
Practice Address - Country:US
Practice Address - Phone:502-587-9478
Practice Address - Fax:502-589-4267
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY01033890A207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64180870Medicaid
C66610Medicare UPIN
KY1385301Medicare ID - Type Unspecified