Healthcare Provider Details

I. General information

NPI: 1275498990
Provider Name (Legal Business Name): ANGELY M CORCHADO MELENDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 88
SABANA HOYOS PR
00688-0088
US

IV. Provider business mailing address

PO BOX 88
SABANA HOYOS PR
00688-0088
US

V. Phone/Fax

Practice location:
  • Phone: 939-375-4065
  • Fax:
Mailing address:
  • Phone: 939-375-4065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number8682
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: