Provider Demographics
NPI:1336549781
Name:AMARNATH, MELISSA (ITDS)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:AMARNATH
Suffix:
Gender:F
Credentials:ITDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 BOSQUE CIR APT 208
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-3233
Mailing Address - Country:US
Mailing Address - Phone:407-473-0522
Mailing Address - Fax:
Practice Address - Street 1:2775 BOSQUE CIR APT 208
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-3233
Practice Address - Country:US
Practice Address - Phone:407-473-0522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-03
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No252Y00000XAgenciesEarly Intervention Provider Agency