Provider Demographics
NPI:1548631021
Name:MELENDEZ VAZQUEZ, IOWANY (PSYD)
Entity type:Individual
Prefix:DR
First Name:IOWANY
Middle Name:
Last Name:MELENDEZ VAZQUEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DL8 CALLE 203
Mailing Address - Street 2:VALLE ARRIBA HEIGHTS
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983
Mailing Address - Country:US
Mailing Address - Phone:787-599-8338
Mailing Address - Fax:
Practice Address - Street 1:1452 AVE ASHFORD
Practice Address - Street 2:COND. ADA LIGIA SUITE 409-A
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-1581
Practice Address - Country:US
Practice Address - Phone:787-402-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-09
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3260103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical