Healthcare Provider Details

I. General information

NPI: 1013975366
Provider Name (Legal Business Name): MELCHOR MADARANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11515 RIVERSTONE CIR APT 10105
OXFORD FL
34484-2361
US

IV. Provider business mailing address

410 W GULF ATLANTIC HWY
WILDWOOD FL
34785-7301
US

V. Phone/Fax

Practice location:
  • Phone: 352-565-7675
  • Fax: 352-706-2445
Mailing address:
  • Phone: 352-565-7675
  • Fax: 352-706-2445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number25MA07398100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0059223
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberD0059223
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME122301
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: