Provider Demographics
NPI:1184732489
Name:MELLMAN, MICHAEL J (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:MELLMAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:10150 HAGEN RANCH RD
Mailing Address - Street 2:STE 201
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3776
Mailing Address - Country:US
Mailing Address - Phone:561-374-8969
Mailing Address - Fax:561-374-8929
Practice Address - Street 1:10150 HAGEN RANCH RD
Practice Address - Street 2:STE 201
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3776
Practice Address - Country:US
Practice Address - Phone:561-374-8969
Practice Address - Fax:561-374-8929
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2018-07-05
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Provider Licenses
StateLicense IDTaxonomies
FLME60362207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14496ZMedicare PIN