Provider Demographics
NPI:1679809917
Name:ALICEA MELENDEZ, JAVIER J
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:J
Last Name:ALICEA MELENDEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 66
Mailing Address - Street 2:
Mailing Address - City:ARROYO
Mailing Address - State:PR
Mailing Address - Zip Code:00714-0066
Mailing Address - Country:US
Mailing Address - Phone:787-374-9071
Mailing Address - Fax:
Practice Address - Street 1:AVE. PEDRO ALBIZU CAMPOS URB. LA HACIENDA
Practice Address - Street 2:HOSPITAL SAN LUCAS GUAYAMA
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-864-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-21
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17721208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice