Provider Demographics
NPI:1760155493
Name:MELVIN, JAMES HARDING III
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:HARDING
Last Name:MELVIN
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7211 VENETIAN ST APT 3
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-2670
Mailing Address - Country:US
Mailing Address - Phone:305-795-0565
Mailing Address - Fax:
Practice Address - Street 1:20000 NW 27TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-2674
Practice Address - Country:US
Practice Address - Phone:305-795-0565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-28
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty