Provider Demographics
NPI:1164843868
Name:CARR, MELANIE MILLER (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:MILLER
Last Name:CARR
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4727 HIGHWAY 90
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-1403
Mailing Address - Country:US
Mailing Address - Phone:850-995-7821
Mailing Address - Fax:
Practice Address - Street 1:4727 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:PACE
Practice Address - State:FL
Practice Address - Zip Code:32571-1403
Practice Address - Country:US
Practice Address - Phone:850-995-7821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-23
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS51263183500000X
UT6246315-1701183500000X
UT6246315-8911183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist