Provider Demographics
NPI:1376603621
Name:MEILUS, ALGIS ALBERT (SPECIALIST)
Entity Type:Individual
Prefix:MR
First Name:ALGIS
Middle Name:ALBERT
Last Name:MEILUS
Suffix:
Gender:M
Credentials:SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 N TESSIER DR
Mailing Address - Street 2:
Mailing Address - City:ST PETE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33706-2815
Mailing Address - Country:US
Mailing Address - Phone:727-360-3913
Mailing Address - Fax:
Practice Address - Street 1:8301 49TH ST
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-1540
Practice Address - Country:US
Practice Address - Phone:727-547-1233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA-0009728174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA-0009728OtherFLORIDA STATE MASSAGE LIC