Provider Demographics
NPI:1467866996
Name:SEALS, MELISSIA MICHELLE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSIA
Middle Name:MICHELLE
Last Name:SEALS
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:2995 DREW ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-532-1355
Mailing Address - Fax:813-635-2613
Practice Address - Street 1:4612 N HABANA AVE FL 2
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-7101
Practice Address - Country:US
Practice Address - Phone:813-875-9000
Practice Address - Fax:813-874-3278
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-103604363LA2100X, 363L00000X, 363LG0600X
FLAPRN11009172363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108583800Medicaid