MEDICARE: MS. LINDA SUSAN MELNICK R.PH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS 18602	FL

General Provider Information

NPI Number	:	1154666089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA SUSAN MELNICK R.PH.

Provider Business Mailing Address
First Line	:	7970 BAYBERRY RD
Second Line	:	SUITE 4
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-7480
Country	:	US
Telephone Number	:	904-733-6099
Fax Number	:	800-888-4121

Provider Business Practice Location Address
First Line	:	7970 BAYBERRY RD
Second Line	:	SUITE 4
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-7480
Country	:	US
Telephone Number	:	904-733-6099
Fax Number	:	800-888-4121

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2012
Last Update Date	:	12/04/2012

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