Provider Demographics
NPI:1992192223
Name:MESSINA, MELISSA SONIA (MS, BCBA)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:SONIA
Last Name:MESSINA
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 DEERBROOKE CREEK CIR APT 3
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-4155
Mailing Address - Country:US
Mailing Address - Phone:772-333-5426
Mailing Address - Fax:
Practice Address - Street 1:7441 114TH AVENUE
Practice Address - Street 2:SUITE 604
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773
Practice Address - Country:US
Practice Address - Phone:727-492-5369
Practice Address - Fax:727-544-5900
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-24
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
246Z00000X
FL0-17-8003103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL247200000XOtherBLUE CROSS BLUE SHIELD
FL1992192223Medicaid
960000161OtherUNITED HEALTHCARE