Provider Demographics
NPI:1770307043
Name:FONTE, MELISSA (APRN)
Entity type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:
Last Name:FONTE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 NW 112 AVE, APT 324
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172
Mailing Address - Country:US
Mailing Address - Phone:786-695-9795
Mailing Address - Fax:
Practice Address - Street 1:400 NW 112TH AVE APT 324
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-4187
Practice Address - Country:US
Practice Address - Phone:786-695-9795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-13
Last Update Date:2024-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2024066828363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily