Healthcare Provider Details

I. General information

NPI: 1124801469
Provider Name (Legal Business Name): MEL-CARO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2023
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2255 SW 32ND AVE STE 201-202
MIAMI FL
33145-3177
US

IV. Provider business mailing address

2255 SW 32ND AVE STE 201-202
MIAMI FL
33145-3177
US

V. Phone/Fax

Practice location:
  • Phone: 786-763-5477
  • Fax:
Mailing address:
  • Phone: 786-763-5477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FERNANDO E MELGAR SOMOZA
Title or Position: PRINCIPAL INVESTIGATOR
Credential: MD
Phone: 786-763-5477