Healthcare Provider Details

I. General information

NPI: 1467993832
Provider Name (Legal Business Name): MELANIE GARCIA BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2017
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PLAZA CAPARRA SHOPPING CENTER SUITE 204
GUAYNABO PR
00926
US

IV. Provider business mailing address

3MN13 VIA 67 URB VILLA FONTANA
CAROLINA PR
00983-4644
US

V. Phone/Fax

Practice location:
  • Phone: 787-777-1616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number57312G
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number83292
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: