Provider Demographics
NPI:1851060156
Name:GABRIELLI, MELANY (PA)
Entity type:Individual
Prefix:
First Name:MELANY
Middle Name:
Last Name:GABRIELLI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:MELANY
Other - Middle Name:
Other - Last Name:SKIRROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4216 MAYFAIR LN
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-7511
Mailing Address - Country:US
Mailing Address - Phone:843-729-3163
Mailing Address - Fax:
Practice Address - Street 1:60 MEMORIAL MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-5980
Practice Address - Country:US
Practice Address - Phone:386-586-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant