Provider Demographics
NPI:1659099224
Name:MILFORT, MELISSA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:MILFORT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10730 CAMERON CT APT 304
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4176
Mailing Address - Country:US
Mailing Address - Phone:954-993-8255
Mailing Address - Fax:
Practice Address - Street 1:288 UNION AVE
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3115
Practice Address - Country:US
Practice Address - Phone:954-993-8255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-18
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS61565183500000X
NHEL10011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist