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MEDI MELBOURNE LLC NPI 1700256450


NPI Information

NPI: 1700256450
Provider Name: MEDI MELBOURNE LLC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
7630 N WICKHAM RD
SUITE 104
MELBOURNE, FL
ZIP 32940
Phone: (321) 610-7982
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MEDI MELBOURNE LLC is a general practice in Melbourne, FL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee MEDI MELBOURNE LLC NPI is 1700256450. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7630 N WICKHAM RD
SUITE 104
MELBOURNE, FL
ZIP 32940-257
Phone: (321) 610-7982

The provider's authorized official is Thomas K Willett .
The authorized official title is Managing Member and has the following contact phone number (813) 245-5305.

The enumeration date for this NPI number is 10/6/2015 and was last updated on 10/26/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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