Provider Demographics
NPI:1851612576
Name:STEVEN J MELILLI D C P A
Entity Type:Organization
Organization Name:STEVEN J MELILLI D C P A
Other - Org Name:MELILLI CHIROPRACTIC AND REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MELILLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-723-9685
Mailing Address - Street 1:2655 STATE ROAD 580
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-3167
Mailing Address - Country:US
Mailing Address - Phone:727-723-9685
Mailing Address - Fax:
Practice Address - Street 1:2655 STATE ROAD 580
Practice Address - Street 2:SUITE 204
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3167
Practice Address - Country:US
Practice Address - Phone:727-723-9685
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-16
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH7232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381054200Medicaid
FL55500AMedicare Oscar/Certification
FL381054200Medicaid