Provider Demographics
NPI:1942325998
Name:QADRI, MELISSA MARRERO (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARRERO
Last Name:QADRI
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 SW 46TH CT
Mailing Address - Street 2:APT. 805
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6264
Mailing Address - Country:US
Mailing Address - Phone:352-817-4765
Mailing Address - Fax:
Practice Address - Street 1:3001 SW 24TH AVE
Practice Address - Street 2:APT. 1807
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-7817
Practice Address - Country:US
Practice Address - Phone:352-817-4765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9030235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL891479600Medicaid
FL344828OtherATA- HEALTHEASE
FL888480300Medicaid