Provider Demographics
NPI:1477329746
Name:LEWIS, MELANIE (RD)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:LEWIS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 DOWSE CT NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-4510
Mailing Address - Country:US
Mailing Address - Phone:570-592-8900
Mailing Address - Fax:
Practice Address - Street 1:1404 DOWSE CT NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-4510
Practice Address - Country:US
Practice Address - Phone:570-592-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered