Provider Demographics
NPI:1134665912
Name:WOO, MELISSA ASHLEY (MD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ASHLEY
Last Name:WOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 WESTON RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3602
Mailing Address - Country:US
Mailing Address - Phone:954-659-5883
Mailing Address - Fax:954-659-5595
Practice Address - Street 1:3100 WESTON RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3602
Practice Address - Country:US
Practice Address - Phone:954-659-5883
Practice Address - Fax:954-659-5595
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FL142039208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program