Provider Demographics
NPI:1467916486
Name:RANKOW, MELISSA CAROLINE RAY (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:CAROLINE RAY
Last Name:RANKOW
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:CAROLINE
Other - Last Name:RAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11031 LEGACY BLVD
Mailing Address - Street 2:APT 102
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3621
Mailing Address - Country:US
Mailing Address - Phone:561-313-2729
Mailing Address - Fax:
Practice Address - Street 1:210 JUPITER LAKES BLVD STE 105
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7187
Practice Address - Country:US
Practice Address - Phone:561-748-4445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant