Provider Demographics
NPI:1285820233
Name:BYRD, MELISSA CAROLYN (APRN)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:CAROLYN
Last Name:BYRD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:CAROLYN
Other - Last Name:CARMICHAEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 917770
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 TAMPA GENERAL CIR FL 7
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3603
Practice Address - Country:US
Practice Address - Phone:813-259-0965
Practice Address - Fax:813-259-0858
Is Sole Proprietor?:No
Enumeration Date:2007-09-23
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9202820363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY134VOtherBLUE CROSS BLUE SHIELD
FL000523500Medicaid
FL000523500Medicaid
FLP00898681Medicare PIN