Provider Demographics
NPI:1558000141
Name:MYLINARSKI, MELINDA SUE
Entity type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:SUE
Last Name:MYLINARSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5706 39TH STREET CIR E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-5500
Mailing Address - Country:US
Mailing Address - Phone:314-703-0355
Mailing Address - Fax:
Practice Address - Street 1:10314 N DALE MABRY
Practice Address - Street 2:HWY 659
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618
Practice Address - Country:US
Practice Address - Phone:314-703-0355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist