MEDICARE: ILEANA EILEEN OCASIO MELENDEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	18534	PR

General Provider Information

NPI Number	:	1013140292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ILEANA EILEEN OCASIO MELENDEZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 365067
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00936-5067
Country	:	US
Telephone Number	:	787-777-3535
Fax Number	:

Provider Business Practice Location Address
First Line	:	1008 AVE AMERICO MIRANDA
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00921-2842
Country	:	US
Telephone Number	:	787-758-7908
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2009
Last Update Date	:	07/10/2024

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