Provider Demographics
NPI:1477577070
Name:RIX, MELINDA DEAN (ARNP)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:DEAN
Last Name:RIX
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10808
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33679-0808
Mailing Address - Country:US
Mailing Address - Phone:813-870-3971
Mailing Address - Fax:813-872-6594
Practice Address - Street 1:12502 USF PINE DRIVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-9499
Practice Address - Country:US
Practice Address - Phone:813-975-7130
Practice Address - Fax:813-975-7129
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2950662363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL302686800Medicaid