MEDICARE: WILLIAM GRASSETTE MELENDEZ 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	208D00000X	General Practice Physician	10816	PR

General Provider Information

NPI Number	:	1972515856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM GRASSETTE MELENDEZ MD

Provider Business Mailing Address
First Line	:	229 CALLE DEL PARQUE
Second Line	:	COND. PARQUE CENTRAL APT. 904
City	:	SAN JUAN
State	:	PR
Zip	:	00912-3223
Country	:	US
Telephone Number	:	787-795-2935
Fax Number	:

Provider Business Practice Location Address
First Line	:	3474 PASEO CAMARON
Second Line	:	3RA SECCION LEVITTOWN
City	:	TOA BAJA
State	:	PR
Zip	:	00949-3634
Country	:	US
Telephone Number	:	787-795-2521
Fax Number	:	787-795-2289

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

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	04/11/2018

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