Provider Demographics
NPI:1508881467
Name:BAADE, MELODY NOEL (MD)
Entity Type:Individual
Prefix:
First Name:MELODY
Middle Name:NOEL
Last Name:BAADE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELODY
Other - Middle Name:N
Other - Last Name:MERRELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4033 TAMPA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3224
Mailing Address - Country:US
Mailing Address - Phone:813-854-2003
Mailing Address - Fax:813-855-2367
Practice Address - Street 1:1850 CROSSINGS BLVD UNIT 100
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:FL
Practice Address - Zip Code:33556-6106
Practice Address - Country:US
Practice Address - Phone:813-475-7100
Practice Address - Fax:813-475-7119
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0049336208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL048830500Medicaid
D21043Medicare UPIN