Active NPI
Luis Melendez, CFA
- Surgical Assistant
- Jacksonville, FL
National Provider Identifier
1023157203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Assistant
- License
- 97966
- Practice address
- 1401 Riverplace Blvd
# 610
Jacksonville, FL 32207-9069 - Phone
- (904) 962-8932
- NPI assigned
- Feb 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Assistant | 246ZC0007X | 97966 | FL | Primary |
Addresses
Primary practice location
1401 Riverplace Blvd
# 610
Jacksonville, FL 32207-9069
Mailing address
1401 Riverplace Blvd
Suite# 610
Jacksonville, FL 32207-9069
Phone (904) 962-8932
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 97966 | FL | MD | Surgical Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232496000000",
"number": "1023157203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 RIVERPLACE BLVD",
"address_2": "SUITE# 610",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322079069",
"telephone_number": "904-962-8932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 RIVERPLACE BLVD",
"address_2": "# 610",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322079069",
"telephone_number": "904-962-8932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELENDEZ",
"first_name": "LUIS",
"credential": "CFA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-05",
"last_updated": "2009-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "FL",
"license": "97966",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.