Provider Demographics
NPI:1780195438
Name:MURPHY, MELISSA (PT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12220 TOWNE LAKE DR STE 1
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8021
Mailing Address - Country:US
Mailing Address - Phone:239-433-6700
Mailing Address - Fax:
Practice Address - Street 1:12220 TOWNE LAKE DR STE 1
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-8021
Practice Address - Country:US
Practice Address - Phone:239-433-6700
Practice Address - Fax:239-433-6703
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-21
Last Update Date:2025-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT30607222Q00000X, 2251P0200X, 225100000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist