Active NPI
Jose Emanuel Melendez Gonzalez, MD
- Student in an Organized Health Care Education/Training Program
- Miami, FL
National Provider Identifier
1336766302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 11750 SW 40TH St
Miami, FL 33175-3530 - Phone
- (305) 223-3000
- NPI assigned
- Jun 25, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 15456-I | PR | |
| Student in an Organized Health Care Education/Training Program | 390200000X | PR | Primary |
Addresses
Primary practice location
11750 SW 40TH St
Miami, FL 33175-3530
Mailing address
Urb Medina Calle 5
Casa D-40
Isabela, PR 00662-3833
Phone (787) 454-9128
Other practice location 1
Avenida Severiano Cuevas
#18 Km. 141.1 Bo. Caimital Bajo
Aguadilla, PR 00603
Phone (787) 658-0000 ext. 1019
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230620001457 | FL | Order and Referring Only - Internal Medicine | 3870951122 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15456-I | PR | MD | Student in an Organized Health Care Education/Training Program |
Interoperability endpoints
- jose.melendezgonzalez@hca4.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679184000000",
"number": "1336766302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "URB MEDINA CALLE 5",
"address_2": "CASA D-40",
"city": "ISABELA",
"state": "PR",
"postal_code": "006623833",
"telephone_number": "787-454-9128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11750 SW 40TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331753530",
"telephone_number": "305-223-3000"
}
],
"practiceLocations": [
{
"address_1": "Avenida Severiano Cuevas",
"address_2": "#18 Km. 141.1 Bo. Caimital Bajo",
"address_purpose": "LOCATION",
"city": "Aguadilla",
"state": "PR",
"postal_code": "00603",
"country_code": "US",
"telephone_number": "787-658-0000 x1019",
"fax_number": "787-819-0805",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MELENDEZ GONZALEZ",
"first_name": "JOSE",
"middle_name": "EMANUEL",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-25",
"last_updated": "2023-03-19",
"certification_date": "2023-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PR",
"license": "15456-I",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "PR",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.