Healthcare Provider Details

I. General information

NPI: 1134057284
Provider Name (Legal Business Name): KARELYN FONTANEZ MELENDEZ PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. CORCHADO FINAL
CANOVANAS PR
00729
US

IV. Provider business mailing address

HC 66 BOX 7238
FAJARDO PR
00738-9269
US

V. Phone/Fax

Practice location:
  • Phone: 787-876-5000
  • Fax:
Mailing address:
  • Phone: 939-400-5220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number3136
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3136
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: