Provider Demographics
NPI:1386878635
Name:ROSKOS, MELINDA (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:
Last Name:ROSKOS
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 34TH AVE N UNIT 7441
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33734-8018
Mailing Address - Country:US
Mailing Address - Phone:813-563-3180
Mailing Address - Fax:
Practice Address - Street 1:901 34TH AVE N UNIT 7441
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33734
Practice Address - Country:US
Practice Address - Phone:813-563-3180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0035410207R00000X
WI64146-020207RC0000X
FL124385207RC0000X
FLOS11694207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015427000FMedicaid
FL015427000FMedicaid