MEDICARE: MARIA TERESA MELLA MD

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	207VM0101X	Maternal & Fetal Medicine Physician	265332	NY
2	207VM0101X	Maternal & Fetal Medicine Physician	ME151966	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184897381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA TERESA MELLA MD

Provider Business Mailing Address
First Line	:	16400 NW 2ND AVE STE 101
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33169-6035
Country	:	US
Telephone Number	:	786-416-6990
Fax Number	:	786-975-1658

Provider Business Practice Location Address
First Line	:	16400 NW 2ND AVE STE 101
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33169-6035
Country	:	US
Telephone Number	:	786-416-6990
Fax Number	:	786-975-1658

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

Provider Enumeration Date	:	04/08/2008
Last Update Date	:	03/14/2022

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Directions to “ MARIA TERESA MELLA MD” Practice Location

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