Healthcare Provider Details

I. General information

NPI: 1902229693
Provider Name (Legal Business Name): ROLANDO M. MELENDEZ DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2014
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5213 ROOSEVELT AVE FL 1
WOODSIDE NY
11377-8054
US

IV. Provider business mailing address

5213 ROOSEVELT AVE FL 1
WOODSIDE NY
11377-8054
US

V. Phone/Fax

Practice location:
  • Phone: 347-696-4113
  • Fax: 347-696-4113
Mailing address:
  • Phone: 347-696-4113
  • Fax: 347-696-4113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number006580
License Number StateNY

VIII. Authorized Official

Name: DR. ROLANDO M MELENDEZ
Title or Position: PODIATRIST
Credential: DPM
Phone: 347-696-4113