Provider Demographics
NPI:1154865129
Name:MELERINE, HOLDEN JAMES (DC)
Entity Type:Individual
Prefix:
First Name:HOLDEN
Middle Name:JAMES
Last Name:MELERINE
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 1:1212 OSPREY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:EUSTIS
Mailing Address - State:FL
Mailing Address - Zip Code:32736-2508
Mailing Address - Country:US
Mailing Address - Phone:504-427-6863
Mailing Address - Fax:
Practice Address - Street 1:910 OLD CAMP RD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5604
Practice Address - Country:US
Practice Address - Phone:352-775-2180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-11
Last Update Date:2022-09-16
Deactivation Date:2022-08-29
Deactivation Code:
Reactivation Date:2022-09-15
Provider Licenses
StateLicense IDTaxonomies
LA390200000X
FLCH-13307111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program