Provider Demographics
NPI:1609266055
Name:WEBBER, MELISSA (PHARMD MHA)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:WEBBER
Suffix:
Gender:F
Credentials:PHARMD MHA
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:HOLEHOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10623 GIBSONTON DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-5404
Mailing Address - Country:US
Mailing Address - Phone:813-677-4435
Mailing Address - Fax:813-677-4063
Practice Address - Street 1:10623 GIBSONTON DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-5404
Practice Address - Country:US
Practice Address - Phone:813-677-4435
Practice Address - Fax:813-677-4063
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-23
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS58390183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS58390OtherFLORIDA DEPARTMENT OF HEALTH