MEDICARE: DR. MARIA ELOISA MELENDEZ DMD

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	1223G0001X	General Practice Dentistry	1009	PR

General Provider Information

NPI Number	:	1427127554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA ELOISA MELENDEZ DMD

Provider Business Mailing Address
First Line	:	1634 CALLE JOSEMARIA ESCRIVA
Second Line	:	EXT.ALHAMBRA
City	:	PONCE
State	:	PR
Zip	:	00716-3811
Country	:	US
Telephone Number	:	787-842-0338
Fax Number	:	787-842-0338

Provider Business Practice Location Address
First Line	:	2909 AVE EMILIO FAGOT
Second Line	:
City	:	PONCE
State	:	PR
Zip	:	00716-3613
Country	:	US
Telephone Number	:	787-842-0338
Fax Number	:	787-842-0338

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	07/08/2007

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