Provider Demographics
NPI:1013971068
Name:MELILLI, STEVEN J (D C P A)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:MELILLI
Suffix:
Gender:M
Credentials:D C P A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 STATE ROAD #580
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761
Mailing Address - Country:US
Mailing Address - Phone:727-723-9685
Mailing Address - Fax:727-723-1925
Practice Address - Street 1:2655 STATE RD. #580
Practice Address - Street 2:SUITE 204
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761
Practice Address - Country:US
Practice Address - Phone:727-723-9685
Practice Address - Fax:727-723-1925
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0007232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU69382Medicare UPIN