Provider Demographics
NPI:1477932788
Name:MELERO, YOUSIT
Entity Type:Individual
Prefix:
First Name:YOUSIT
Middle Name:
Last Name:MELERO
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 1:14265 SW 23RD LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-8020
Mailing Address - Country:US
Mailing Address - Phone:305-781-1404
Mailing Address - Fax:305-552-9953
Practice Address - Street 1:14265 SW 23RD LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-8020
Practice Address - Country:US
Practice Address - Phone:305-781-1404
Practice Address - Fax:305-552-9953
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA11683224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOTA11683OtherLICENSE NO