Provider Demographics
NPI:1528340916
Name:RAKAUSKAS, MELISSA (BS)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:RAKAUSKAS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7003 PRESIDENTS DR.
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809
Mailing Address - Country:US
Mailing Address - Phone:407-859-6197
Mailing Address - Fax:407-859-6442
Practice Address - Street 1:7003 PRESIDENTS DR
Practice Address - Street 2:SUITE 250
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809
Practice Address - Country:US
Practice Address - Phone:407-859-6197
Practice Address - Fax:407-859-6442
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0027544183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist