Provider Demographics
NPI:1689103830
Name:MELCHIORRE, JOSEPH ROCCO (HAS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ROCCO
Last Name:MELCHIORRE
Suffix:
Gender:M
Credentials:HAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409 CLEVELAND HEIGHTS BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-4807
Mailing Address - Country:US
Mailing Address - Phone:863-646-6663
Mailing Address - Fax:
Practice Address - Street 1:3409 CLEVELAND HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4807
Practice Address - Country:US
Practice Address - Phone:863-646-6663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5215237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist