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General NPI Number Information
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NPI Number | 1417462003
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Entity Type | Individual
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Provider Name | MARISOL M MELENDEZ RDCS, RVT
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Gender | Female
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 902 WILLOW DR
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City | LEHIGH ACRES
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State | FL
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Zip | 33936-6765
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Country | US
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Telephone | 732-771-7888
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Fax |
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Provider Business Mailing Address
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Address Line | 902 WILLOW DR
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City | LEHIGH ACRES
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State | FL
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Zip | 33936-6765
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Country | US
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Telephone | 732-771-7888
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246XS1301X
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Taxonomy Name | Sonography Specialist/Technologist Cardiovascular
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License Number | 142552
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License Number State | NC
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