Provider Demographics
NPI:1861707457
Name:MELENDEZ GARCIA, MELANIE (MD)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:MELENDEZ GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13920 LANDSTAR BLVD # 45
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-5524
Mailing Address - Country:US
Mailing Address - Phone:863-800-5323
Mailing Address - Fax:
Practice Address - Street 1:1213 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4407
Practice Address - Country:US
Practice Address - Phone:407-483-4795
Practice Address - Fax:863-250-1174
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20857207P00000X
PR12,636 - I390200000X
FLME-119966207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program