Basic Information
| Provider Information | |||||||||
| NPI: | 1366561557 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MELENDEZ PAGAN | ||||||||
| FirstName: | BEBELIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 89 AVE DE DIEGO STE 105 | ||||||||
| Address2: | PMB 619 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009276370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877483818 | ||||||||
| FaxNumber: | 7877483818 | ||||||||
| Practice Location | |||||||||
| Address1: | 300 BLVD RAMALLO | ||||||||
| Address2: | CARR # 1 OFF 213 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 009269786 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877483818 | ||||||||
| FaxNumber: | 7877483818 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 13724 | PR | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.