Provider Demographics
NPI:1184092132
Name:MAXWELL, MELROSE (RN)
Entity type:Individual
Prefix:
First Name:MELROSE
Middle Name:
Last Name:MAXWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1934 SW 149TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4339
Mailing Address - Country:US
Mailing Address - Phone:305-263-0732
Mailing Address - Fax:754-400-8028
Practice Address - Street 1:1934 SW 149TH AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4339
Practice Address - Country:US
Practice Address - Phone:305-263-0732
Practice Address - Fax:754-400-8028
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9247566163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management