Healthcare Provider Details

I. General information

NPI: 1104769421
Provider Name (Legal Business Name): MELANIE ESTEFANIA QUINONES CANDELARIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

7150 W 20TH AVE STE 311
HIALEAH FL
33016-5532
US

IV. Provider business mailing address

234 CALLE MIOSOTIS
CAROLINA PR
00987-8774
US

V. Phone/Fax

Practice location:
  • Phone: 305-823-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: