Provider Demographics
NPI:1669760799
Name:PUZZO, MELISSA MARIE (OD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:MARIE
Last Name:PUZZO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:MARIE
Other - Last Name:GORSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1755 S BEELER ST UNIT 10G
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-2912
Mailing Address - Country:US
Mailing Address - Phone:407-308-8125
Mailing Address - Fax:
Practice Address - Street 1:9390 W CROSS DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-2202
Practice Address - Country:US
Practice Address - Phone:720-922-1539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4972152W00000X
NY56 007744152W00000X
COOPT3248152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist