Provider Demographics
NPI:1922364660
Name:PAUL I MELI III MD PA
Entity Type:Organization
Organization Name:PAUL I MELI III MD PA
Other - Org Name:MELI ORTHOPEDIC CENTERS OF EXCELLENC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRIGIDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FENELON
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:954-580-4080
Mailing Address - Street 1:2964 N STATE ROAD 7
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5715
Mailing Address - Country:US
Mailing Address - Phone:954-580-4080
Mailing Address - Fax:954-580-4081
Practice Address - Street 1:2964 N STATE ROAD 7
Practice Address - Street 2:SUITE 205
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063
Practice Address - Country:US
Practice Address - Phone:954-580-4080
Practice Address - Fax:954-580-4081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057725174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE59294Medicare UPIN
10842ZMedicare PIN