Provider Demographics
NPI:1396860664
Name:NORIEGA, MELECIA N (RPH)
Entity Type:Individual
Prefix:
First Name:MELECIA
Middle Name:N
Last Name:NORIEGA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9220 PALM RIVER RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-4476
Mailing Address - Country:US
Mailing Address - Phone:813-637-2600
Mailing Address - Fax:
Practice Address - Street 1:9220 PALM RIVER RD
Practice Address - Street 2:SUITE 105
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-4476
Practice Address - Country:US
Practice Address - Phone:813-637-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2009-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist