Provider Demographics
NPI:1003143892
Name:MELOGRANO, ALLISON MARIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:MARIE
Last Name:MELOGRANO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2900 CORPORATE WAY
Mailing Address - Street 2:MPG DOOR D
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-3925
Mailing Address - Country:US
Mailing Address - Phone:954-276-5581
Mailing Address - Fax:954-985-7074
Practice Address - Street 1:1150 N 35TH AVE
Practice Address - Street 2:SUITE 490
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5424
Practice Address - Country:US
Practice Address - Phone:954-265-1616
Practice Address - Fax:954-893-6325
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY 1589231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL005471700Medicaid