Provider Demographics
NPI:1730103698
Name:SKAFF-SCHULTZ, MELISSA M (ARNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:M
Last Name:SKAFF-SCHULTZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28960 US HIGHWAY 19 N STE 100
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-2403
Mailing Address - Country:US
Mailing Address - Phone:727-787-7970
Mailing Address - Fax:727-787-8524
Practice Address - Street 1:28960 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 100
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2403
Practice Address - Country:US
Practice Address - Phone:727-787-7970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1526022363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7949WMedicare UPIN
P68254Medicare UPIN