Healthcare Provider Details
I. General information
NPI: 1326180092
Provider Name (Legal Business Name): NANCY R SEDA MELENDEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/12/2007
Last Update Date: 10/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
BO MONTALVA 23 ENSENADA MIGRANT HEALTH CENTER, INC
GUANICA PR
00647
US
IV. Provider business mailing address
PO BOX 7128 MIGRANT HEALTH CENTER, INC
MAYAGUEZ PR
00681-7128
US
V. Phone/Fax
- Phone: 787-821-3377
- Fax: 787-821-5328
- Phone: 787-805-2900
- Fax: 787-834-1924
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 8788 |
| License Number State | PR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: