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NPI Code Detail

MEDICARE: ANDRES ENRIQUE FOSSAS DE MELLO

MEDICARE: ANDRES ENRIQUE FOSSAS DE MELLO
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1285424267
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDRES ENRIQUE FOSSAS DE MELLO
Provider Business Mailing Address
First Line : CONDOMINIO LA ARBOLEDA 87 CARR. 20
Second Line : APT. 504
City : GUAYNABO
State : PR
Zip : 00966
Country : US
Telephone Number : 407-421-5644
Fax Number :
Provider Business Practice Location Address
First Line : 10 CALLE CASIA
Second Line :
City : SAN JUAN
State : PR
Zip : 00921-3200
Country : US
Telephone Number : 787-641-7582
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2025
Last Update Date : 05/27/2026

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Directions to “ ANDRES ENRIQUE FOSSAS DE MELLO ” Practice Location

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