Provider Demographics
NPI:1073900668
Name:MELIA, JUSTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:MELIA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 SAN MARCO RD
Mailing Address - Street 2:STE 203
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34145-5138
Mailing Address - Country:US
Mailing Address - Phone:908-454-2666
Mailing Address - Fax:908-454-3315
Practice Address - Street 1:1770 SAN MARCO RD STE 203
Practice Address - Street 2:
Practice Address - City:MARCO ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34145-5138
Practice Address - Country:US
Practice Address - Phone:239-970-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13470111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor