Provider Demographics
NPI:1407638471
Name:HUME, MELESHIA DEBRON
Entity Type:Individual
Prefix:MISS
First Name:MELESHIA
Middle Name:DEBRON
Last Name:HUME
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 1:5456 NW 122ND DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3638
Mailing Address - Country:US
Mailing Address - Phone:954-793-1655
Mailing Address - Fax:
Practice Address - Street 1:5456 NW 122ND DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33076-3638
Practice Address - Country:US
Practice Address - Phone:954-793-1655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA10871224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant