Provider Demographics
NPI:1568795078
Name:MILIOS, MELVA RITA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MELVA
Middle Name:RITA
Last Name:MILIOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13724 PIMBERTON DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34669-0807
Mailing Address - Country:US
Mailing Address - Phone:727-860-5675
Mailing Address - Fax:727-860-5675
Practice Address - Street 1:12000 US HIGHWAY 19
Practice Address - Street 2:SUITE F
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-2056
Practice Address - Country:US
Practice Address - Phone:727-860-5675
Practice Address - Fax:727-860-5675
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSW83121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFA412AMedicare PIN