Provider Demographics
NPI:1659646446
Name:COEL, MELISSA E (MS, RD, CSO)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:E
Last Name:COEL
Suffix:
Gender:F
Credentials:MS, RD, CSO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SW 9TH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-7111
Mailing Address - Country:US
Mailing Address - Phone:954-243-4216
Mailing Address - Fax:
Practice Address - Street 1:201 SW 9TH AVE APT 3
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-7111
Practice Address - Country:US
Practice Address - Phone:954-243-4216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND5508133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered