MEDICARE: MELANIE BAEZ SA 9615

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	235Z00000X	Speech-Language Pathologist	SA9615	FL

General Provider Information

NPI Number	:	1760670160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE BAEZ SA 9615

Provider Business Mailing Address
First Line	:	3305 S ORANGE AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-6125
Country	:	US
Telephone Number	:	407-852-3310
Fax Number	:	407-852-3301

Provider Business Practice Location Address
First Line	:	239 TOM SAWYER CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-8934
Country	:	US
Telephone Number	:	407-766-8393
Fax Number	:

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

Provider Enumeration Date	:	10/10/2007
Last Update Date	:	03/06/2026

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