Provider Demographics
NPI:1720291248
Name:HEITMAN, MELANIE ELIZABETH (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:ELIZABETH
Last Name:HEITMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 LINWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-3808
Mailing Address - Country:US
Mailing Address - Phone:941-266-7610
Mailing Address - Fax:941-423-6368
Practice Address - Street 1:5380 GULF OF MEXICO DR STE 101
Practice Address - Street 2:
Practice Address - City:LONGBOAT KEY
Practice Address - State:FL
Practice Address - Zip Code:34228-2048
Practice Address - Country:US
Practice Address - Phone:941-426-2800
Practice Address - Fax:941-423-6368
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40424183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist