Provider Demographics
NPI:1396130654
Name:MELLION, STEVEN ROBERT (LNHA)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:ROBERT
Last Name:MELLION
Suffix:
Gender:M
Credentials:LNHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2517 STONEGATE DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-7784
Mailing Address - Country:US
Mailing Address - Phone:561-791-9854
Mailing Address - Fax:
Practice Address - Street 1:2517 STONEGATE DR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-7784
Practice Address - Country:US
Practice Address - Phone:561-791-9854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLNHA 3342314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility