Healthcare Provider Details

I. General information

NPI: 1134028186
Provider Name (Legal Business Name): JANICE C MELENDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2026
Last Update Date: 11/04/2026
Certification Date: 11/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 ROSEWOOD DR
BARTOW FL
33830-6025
US

IV. Provider business mailing address

2110 ROSEWOOD DR
BARTOW FL
33830-6025
US

V. Phone/Fax

Practice location:
  • Phone: 787-960-5020
  • Fax:
Mailing address:
  • Phone: 787-960-5020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: