Provider Demographics
NPI:1215411046
Name:MELTON, AMBER LEIGHANN
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LEIGHANN
Last Name:MELTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7260 S MAGNOLIA AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-8939
Mailing Address - Country:US
Mailing Address - Phone:352-342-2397
Mailing Address - Fax:
Practice Address - Street 1:7260 S MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-8939
Practice Address - Country:US
Practice Address - Phone:352-342-2397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer