MEDICARE: DR. AURORA MELENDEZ COLLAZO MD

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	4787	PR

General Provider Information

NPI Number	:	1831182690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AURORA MELENDEZ COLLAZO MD

Provider Business Mailing Address
First Line	:	PO BOX 591
Second Line	:
City	:	GURABO
State	:	PR
Zip	:	00778-0591
Country	:	US
Telephone Number	:	787-737-3936
Fax Number	:

Provider Business Practice Location Address
First Line	:	EUGENIO SANCHEZ LOPEZ URB. LOS MAESTROS
Second Line	:	A-16
City	:	GURABO
State	:	PR
Zip	:	00778
Country	:	US
Telephone Number	:	787-737-3936
Fax Number	:

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

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	12/11/2009

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