MEDICARE: MELU-JEAN RONGO 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	207L00000X	Anesthesiology Physician	ME93132	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00244526	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	16061	OTHER	FL	BC/BS FL
2	301033	OTHER		AMERIGROUP
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184604647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELU-JEAN RONGO M.D.

Provider Business Mailing Address
First Line	:	9630 PINEAPPLE PRESERVE CT
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-9726
Country	:	US
Telephone Number	:	239-939-2622
Fax Number	:	239-939-0151

Provider Business Practice Location Address
First Line	:	12511 WORLD PLAZA LN BLDG 50
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-3991
Country	:	US
Telephone Number	:	239-939-2622
Fax Number	:	239-939-0151

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

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	02/28/2013

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Directions to “ MELU-JEAN RONGO M.D.” Practice Location

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