Provider Demographics
NPI:1184833097
Name:MELTZER, DESSIE D (ARNP C)
Entity Type:Individual
Prefix:
First Name:DESSIE
Middle Name:D
Last Name:MELTZER
Suffix:
Gender:F
Credentials:ARNP C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1099 5TH AVE N
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1469
Mailing Address - Country:US
Mailing Address - Phone:727-820-7800
Mailing Address - Fax:727-820-7801
Practice Address - Street 1:23476 W US HIGHWAY 27
Practice Address - Street 2:
Practice Address - City:HIGH SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32643-2108
Practice Address - Country:US
Practice Address - Phone:386-454-0568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2218082363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health