Healthcare Provider Details

I. General information

NPI: 1548631021
Provider Name (Legal Business Name): IOWANY MELENDEZ VAZQUEZ PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2015
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVE. PASEO DE LOS GIGANTES VIA 21 RL9 (2DO PISO)
CAROLINA PR
00983
US

IV. Provider business mailing address

PO BOX 269
LUQUILLO PR
00773-0269
US

V. Phone/Fax

Practice location:
  • Phone: 787-402-2000
  • Fax:
Mailing address:
  • Phone: 787-599-8338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3260
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: