Provider Demographics
NPI:1114207768
Name:ANTONE, MELISSA KAY
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:KAY
Last Name:ANTONE
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 1:6200 HALYARD CT
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-5762
Mailing Address - Country:US
Mailing Address - Phone:321-223-5359
Mailing Address - Fax:
Practice Address - Street 1:6200 HALYARD CT
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-5762
Practice Address - Country:US
Practice Address - Phone:321-223-5359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist