Provider Demographics
NPI:1578711560
Name:BRYANS, MELANEE CHRISTINA (HIS)
Entity Type:Individual
Prefix:
First Name:MELANEE
Middle Name:CHRISTINA
Last Name:BRYANS
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 W GRANADA BLVD
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-5912
Mailing Address - Country:US
Mailing Address - Phone:386-252-6111
Mailing Address - Fax:386-257-5826
Practice Address - Street 1:1199 W GRANADA BLVD
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-5912
Practice Address - Country:US
Practice Address - Phone:386-252-6111
Practice Address - Fax:386-257-5826
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4190237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist