Healthcare Provider Details

I. General information

NPI: 1295656023
Provider Name (Legal Business Name): MELANIE CARRION LAUREANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 AVE JESUS T PINERO
SAN JUAN PR
00921-1722
US

IV. Provider business mailing address

E23 CALLE 15A
SAN JUAN PR
00924-5734
US

V. Phone/Fax

Practice location:
  • Phone: 787-781-3020
  • Fax:
Mailing address:
  • Phone: 787-403-9933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: