Provider Demographics
NPI:1699012468
Name:BLOCK, MELISSA A (PHARMD)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:BLOCK
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 1:4141 N FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4528
Mailing Address - Country:US
Mailing Address - Phone:561-395-1725
Mailing Address - Fax:561-910-4140
Practice Address - Street 1:4141 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4528
Practice Address - Country:US
Practice Address - Phone:561-395-1725
Practice Address - Fax:561-910-4140
Is Sole Proprietor?:No
Enumeration Date:2013-01-13
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS48214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist