MEDICARE: CARLOS ANIBAL MELENDEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	J7090	TX
2	208000000X	Pediatrics Physician	ME 74872	FL
3	208000000X	Pediatrics Physician	MD-052944-L	PA
4	208000000X	Pediatrics Physician	011583	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MD-052944-L	OTHER	PA	PA MEDICAL LICENCE
3	ME 74872	OTHER	FL	FL MEDICAL LICENCE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	011583	OTHER	PR	PR MEDICAL LICENCE

General Provider Information

NPI Number	:	1083616007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS ANIBAL MELENDEZ MD

Provider Business Mailing Address
First Line	:	PO BOX 5624
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77508-5624
Country	:	US
Telephone Number	:	713-477-8888
Fax Number	:	713-477-8885

Provider Business Practice Location Address
First Line	:	908 E SOUTHMORE AVE
Second Line	:	SUITE 290
City	:	PASADENA
State	:	TX
Zip	:	77502-1134
Country	:	US
Telephone Number	:	713-477-8888
Fax Number	:	713-477-8885

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	11/09/2015

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Directions to “ CARLOS ANIBAL MELENDEZ MD” Practice Location

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