Provider Demographics
NPI:1710122817
Name:ANAMDI, MELINDA AMELIA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:AMELIA
Last Name:ANAMDI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:MELINDA
Other - Middle Name:AMELIA
Other - Last Name:SANTIAGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5105 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-1405
Mailing Address - Country:US
Mailing Address - Phone:813-879-8045
Mailing Address - Fax:813-876-6504
Practice Address - Street 1:5105 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1405
Practice Address - Country:US
Practice Address - Phone:813-879-8045
Practice Address - Fax:813-876-6504
Is Sole Proprietor?:No
Enumeration Date:2008-12-04
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013030363AM0700X
FLPA9117549363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical