MEDICARE: MELANIE RYERSON

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1235876525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE RYERSON

Provider Business Mailing Address
First Line	:	6401 S WEST SHORE BLVD APT 1521
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33616-1396
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5009 N CENTRAL AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33603-2213
Country	:	US
Telephone Number	:	727-644-9414
Fax Number	:

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

Provider Enumeration Date	:	05/18/2022
Last Update Date	:	01/13/2025

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Directions to “ MELANIE RYERSON ” Practice Location

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