Provider Demographics
NPI:1235394420
Name:AGUIN MELENDEZ, EDUARDO JOSE (MD)
Entity type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:JOSE
Last Name:AGUIN MELENDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1846 RYE RD
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212-9038
Mailing Address - Country:US
Mailing Address - Phone:941-302-9977
Mailing Address - Fax:941-708-0804
Practice Address - Street 1:1846 RYE RD
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34212-9038
Practice Address - Country:US
Practice Address - Phone:941-302-9977
Practice Address - Fax:941-708-0804
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2024-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301091720207V00000X
FLME147685207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME147685OtherFL MED LIC
FL108902400Medicaid