Provider Demographics
NPI:1093983405
Name:CLEVELAND, MELISSA A (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:A
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 FOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-4160
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5126 SCHOOL RD.
Practice Address - Street 2:
Practice Address - City:LAND O' LAKES
Practice Address - State:FL
Practice Address - Zip Code:34638-3614
Practice Address - Country:US
Practice Address - Phone:813-794-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11358225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist