Provider Demographics
NPI:1134484702
Name:MELICHAR, JAMIE (DO)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:MELICHAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7278 STATE ROAD 54
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-6125
Mailing Address - Country:US
Mailing Address - Phone:727-807-5900
Mailing Address - Fax:727-264-8520
Practice Address - Street 1:7278 STATE ROAD 54
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653
Practice Address - Country:US
Practice Address - Phone:727-807-5900
Practice Address - Fax:727-264-8520
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13020207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine