Provider Demographics
NPI:1700421021
Name:DEMARCHENA, MELISSA M (MS, CF SLP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:DEMARCHENA
Suffix:
Gender:F
Credentials:MS, CF SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8701 SW 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-6960
Mailing Address - Country:US
Mailing Address - Phone:305-333-1525
Mailing Address - Fax:
Practice Address - Street 1:3601 SW 117TH AVE APT 405
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-1765
Practice Address - Country:US
Practice Address - Phone:305-707-1555
Practice Address - Fax:305-716-9236
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ9396235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty