Provider Demographics
NPI:1700488640
Name:MELENDEZ TUR, CORALYS ANDREA (PHARMD)
Entity type:Individual
Prefix:
First Name:CORALYS
Middle Name:ANDREA
Last Name:MELENDEZ TUR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. PRADERA ALMIRA
Mailing Address - Street 2:AJ6 CALLE 6
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949
Mailing Address - Country:US
Mailing Address - Phone:787-420-1661
Mailing Address - Fax:
Practice Address - Street 1:VILLA CAPARRA 178 CARR2
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00966
Practice Address - Country:US
Practice Address - Phone:787-706-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6801183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist