MEDICARE: JOHN HENRY MELENDEZ MORENO

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1437831484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN HENRY MELENDEZ MORENO

Provider Business Mailing Address
First Line	:	URB. LOS FRAILES, CALLE LOS FRAILES, C-14
Second Line	:
City	:	GUAYNABO
State	:	PR
Zip	:	00969
Country	:	US
Telephone Number	:	787-415-6745
Fax Number	:

Provider Business Practice Location Address
First Line	:	LUIS A. FERRE HIGHWAY EXIT #21 ROAD 172 CAGUAS TO CIDRA
Second Line	:	TURABO GARDENS CAGUAS, PR 00725
City	:	CAGUAS
State	:	PR
Zip	:	00727
Country	:	US
Telephone Number	:	787-743-3038
Fax Number	:

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

Provider Enumeration Date	:	08/01/2023
Last Update Date	:	05/07/2026

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