Provider Demographics
NPI:1679160477
Name:MELENDEZ-SANTOS, MELIXA (PT)
Entity Type:Individual
Prefix:
First Name:MELIXA
Middle Name:
Last Name:MELENDEZ-SANTOS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 BARBRI LN
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-6375
Mailing Address - Country:US
Mailing Address - Phone:954-540-8228
Mailing Address - Fax:
Practice Address - Street 1:2033 MAIN ST STE 300
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34237-6062
Practice Address - Country:US
Practice Address - Phone:941-365-3534
Practice Address - Fax:941-952-9331
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT6314225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist