Provider Demographics
NPI:1427764901
Name:DOWLING, MELISSA L (PA-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:L
Last Name:DOWLING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 MEDICAL PARK DR STE 170
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-6601
Mailing Address - Country:US
Mailing Address - Phone:813-421-2979
Mailing Address - Fax:
Practice Address - Street 1:3000 MEDICAL PARK DR STE 170
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-6601
Practice Address - Country:US
Practice Address - Phone:813-421-2979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9116990363A00000X
363AM0700X
FLPAT9116990363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical