Provider Demographics
NPI:1356805931
Name:CAPURRO, MELISSA (PT, DPT, MS)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:CAPURRO
Suffix:
Gender:F
Credentials:PT, DPT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 S ARMENIA AVE UNIT 1219E
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3384
Mailing Address - Country:US
Mailing Address - Phone:917-353-0441
Mailing Address - Fax:
Practice Address - Street 1:609 S HOWARD AVE STE 102
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2412
Practice Address - Country:US
Practice Address - Phone:813-258-2918
Practice Address - Fax:813-258-2930
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT34346225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist