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NPI Code Detail

MEDICARE: LUIS A MELENDEZ-COLLAZO M.D.

MEDICARE:   LUIS A MELENDEZ-COLLAZO  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
1207R00000XInternal Medicine PhysicianME93592FL
2208M00000XHospitalist PhysicianME93592FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P01056129OTHERFLRR MEDICARE

Other Identifiers

General Provider Information

NPI Number : 1760455190
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUIS A MELENDEZ-COLLAZO M.D.
Provider Business Mailing Address
First Line : 38135 MARKET SQ
Second Line :
City : ZEPHYRHILLS
State : FL
Zip : 33542-7505
Country : US
Telephone Number : 813-528-4975
Fax Number :
Provider Business Practice Location Address
First Line : 38135 MARKET SQ
Second Line :
City : ZEPHYRHILLS
State : FL
Zip : 33542-7505
Country : US
Telephone Number : 813-778-0444
Fax Number : 813-355-5084
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2006
Last Update Date : 07/07/2017

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Directions to “ LUIS A MELENDEZ-COLLAZO M.D.” Practice Location

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