Provider Demographics
NPI:1942665575
Name:MELNIK, LYDMILA (ARNP)
Entity Type:Individual
Prefix:
First Name:LYDMILA
Middle Name:
Last Name:MELNIK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13379 COPPER AVE
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33981-5559
Mailing Address - Country:US
Mailing Address - Phone:941-697-3305
Mailing Address - Fax:
Practice Address - Street 1:13379 COPPER AVE
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33981-5559
Practice Address - Country:US
Practice Address - Phone:941-697-3305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-26
Last Update Date:2015-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9247161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily