Provider Demographics
NPI:1679667307
Name:PUMA, MELISSA ANNE
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:ANNE
Last Name:PUMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10631 SW 113TH PL
Mailing Address - Street 2:APT C
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-8284
Mailing Address - Country:US
Mailing Address - Phone:305-279-9887
Mailing Address - Fax:305-279-2435
Practice Address - Street 1:10631 SW 113TH PL
Practice Address - Street 2:APT C
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-8284
Practice Address - Country:US
Practice Address - Phone:305-279-9887
Practice Address - Fax:305-279-2435
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 6059235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist