Provider Demographics
NPI:1497756878
Name:MELIDONA, FRANK JAMES (DO)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:JAMES
Last Name:MELIDONA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1020 LAKE SUMTER LNDG
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-2699
Mailing Address - Country:US
Mailing Address - Phone:352-674-8905
Mailing Address - Fax:352-674-8919
Practice Address - Street 1:1575 SANTA BARBARA BLVD
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-6820
Practice Address - Country:US
Practice Address - Phone:352-674-1740
Practice Address - Fax:352-674-8940
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA0S008145-L207Q00000X
FLOS13041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA468311OtherBC/BS
PA203752OtherUPMC
PA0014301690009Medicaid
PA1027790OtherGATEWAY
PA0014301690009Medicaid
PA1027790OtherGATEWAY