Provider Demographics
NPI:1124432281
Name:MELICHAR, FRANK ANTON (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:ANTON
Last Name:MELICHAR
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 1:1543 CRESTVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-5815
Mailing Address - Country:US
Mailing Address - Phone:850-561-1165
Mailing Address - Fax:
Practice Address - Street 1:1543 CRESTVIEW AVE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-5815
Practice Address - Country:US
Practice Address - Phone:850-561-1165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208342085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology