MEDICARE: DR. LOURDES AIXA 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	208D00000X	General Practice Physician	14556	PR

General Provider Information

NPI Number	:	1568448975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOURDES AIXA MELENDEZ M.D.

Provider Business Mailing Address
First Line	:	CALLE 15-Z5-3
Second Line	:	TURABO GARDENS
City	:	CAGUAS
State	:	PR
Zip	:	00727
Country	:	US
Telephone Number	:	787-646-5984
Fax Number	:	787-734-4690

Provider Business Practice Location Address
First Line	:	TURABO GARDENS
Second Line	:	CALLE 15-Z5-3
City	:	CAGUAS
State	:	PR
Zip	:	00727
Country	:	US
Telephone Number	:	787-646-5984
Fax Number	:	787-734-4690

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

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	07/08/2007

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