Healthcare Provider Details

I. General information

NPI: 1710802160
Provider Name (Legal Business Name): DESIREE MARIE MELENDEZ PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA GUAYNABO CARIBBEAN CINEMAS CE SUITE 205
GUAYNABO PR
00969
US

IV. Provider business mailing address

300 AVE LA SIERRA BOX 10
SAN JUAN PR
00926
US

V. Phone/Fax

Practice location:
  • Phone: 787-781-2034
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number8786
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: