Provider Demographics
NPI:1285754119
Name:MELLO, MELANIE VIRGINIE (ARNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:VIRGINIE
Last Name:MELLO
Suffix:
Gender:F
Credentials:ARNP-BC
Other - Prefix:MRS
Other - First Name:MELANIE
Other - Middle Name:VIRGINIE COTE
Other - Last Name:MELLO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP-BC
Mailing Address - Street 1:20750 NW 176TH AVE
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-3944
Mailing Address - Country:US
Mailing Address - Phone:863-763-4149
Mailing Address - Fax:
Practice Address - Street 1:17201 CIVIC ST.
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34974
Practice Address - Country:US
Practice Address - Phone:863-763-0271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 3167812363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily