MEDICARE: EDWIN M. MELENDEZ, MD PA

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	207XS0106X	Orthopaedic Hand Surgery Physician	0059273	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851622807
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDWIN M. MELENDEZ, MD PA

Provider Business Mailing Address
First Line	:	2509 W CREST AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-6839
Country	:	US
Telephone Number	:	813-878-2105
Fax Number	:	813-875-0213

Provider Business Practice Location Address
First Line	:	2509 W CREST AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-6839
Country	:	US
Telephone Number	:	813-878-2105
Fax Number	:	813-875-0213

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EDWIN M MELENDEZ
Credential	:	MD
Telephone Number	:	813-878-2105

Provider Enumeration Date	:	01/14/2010
Last Update Date	:	08/08/2011

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