Provider Demographics
NPI: | 1942529748 |
---|---|
Name: | BARRIFFE, MELANIE ANGELIA (PA-C) |
Entity Type: | Individual |
Prefix: | MRS |
First Name: | MELANIE |
Middle Name: | ANGELIA |
Last Name: | BARRIFFE |
Suffix: | |
Gender: | F |
Credentials: | PA-C |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 13067 N TELECOM PKWY |
Mailing Address - Street 2: | |
Mailing Address - City: | TEMPLE TERRACE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33637-0926 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 813-779-6303 |
Mailing Address - Fax: | 888-977-1998 |
Practice Address - Street 1: | 13067 N TELECOM PKWY |
Practice Address - Street 2: | |
Practice Address - City: | TEMPLE TERRACE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33637-0926 |
Practice Address - Country: | US |
Practice Address - Phone: | 813-779-6303 |
Practice Address - Fax: | 888-977-1998 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2010-05-19 |
Last Update Date: | 2019-12-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | PA9107771 | 363A00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | IR360Z- PASCO | Medicare PIN | |
FL | P01713993- RAILROAD | Medicare PIN | |
FL | IR360X- MIAMI | Medicare PIN | |
FL | IR360Y- TPA | Medicare PIN |