Active NPI
Liza M Melendez, MD
- Pediatrics Physician
- Port Saint Lucie, FL
National Provider Identifier
1366624645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME126322
- Practice address
- 1850 SW Fountainview Blvd
Suite 105
Port Saint Lucie, FL 34986-3443 - Phone
- (772) 336-2818
- Fax
- (772) 336-5313
- NPI assigned
- Nov 28, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME126322 | FL | Primary |
Addresses
Primary practice location
1850 SW Fountainview Blvd
Suite 105
Port Saint Lucie, FL 34986-3443
Mailing address
900 S Pine Island Rd
Suite 800
Plantation, FL 33324-3920
Phone (772) 336-2818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 016658800 | Medicaid | FL |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME126322 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saltzman, Tanis, Pittell, Levin and Jacobson | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- lmelendez@pa.trimed.direct-ci.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Hollywood, FL
- NPI 1639138480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604361600000",
"number": "1366624645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 S PINE ISLAND RD",
"address_2": "SUITE 800",
"city": "PLANTATION",
"state": "FL",
"postal_code": "333243920",
"telephone_number": "772-336-2818",
"fax_number": "772-336-5313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1850 SW FOUNTAINVIEW BLVD",
"address_2": "SUITE 105",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349863443",
"telephone_number": "772-336-2818",
"fax_number": "772-336-5313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELENDEZ",
"first_name": "LIZA",
"middle_name": "M",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-11-28",
"last_updated": "2020-11-03",
"certification_date": "2020-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME126322",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "016658800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.