MEDICARE: MELPO CSP

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1326037888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MELPO CSP

Provider Business Mailing Address
First Line	:	112 CALLE ARZUAGA
Second Line	:	SUITE 605
City	:	SAN JUAN
State	:	PR
Zip	:	00925-3321
Country	:	US
Telephone Number	:	787-765-3164
Fax Number	:	787-763-0200

Provider Business Practice Location Address
First Line	:	112 CALLE ARZUAGA
Second Line	:	SUITE 605
City	:	SAN JUAN
State	:	PR
Zip	:	00925-3321
Country	:	US
Telephone Number	:	787-765-3164
Fax Number	:	787-763-0200

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. LUIS H MELENDEZ POVENTUN
Credential	:	MD
Telephone Number	:	787-547-3933

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	12/16/2010

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