Healthcare Provider Details

I. General information

NPI: 1316768906
Provider Name (Legal Business Name): JOSUE MELENDEZ ALMODOVAR MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 697 EDIF. VISTA PLAZA, LOTES 106-205 CALLE C
DORADO PR
00646
US

IV. Provider business mailing address

PO BOX 515
NARANJITO PR
00719-0515
US

V. Phone/Fax

Practice location:
  • Phone: 787-869-5900
  • Fax:
Mailing address:
  • Phone: 787-869-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: