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NPI Code Detail

MEDICARE: MELISSA BOUMITRI

MEDICARE: MELISSA BOUMITRI
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
1390200000XStudent in an Organized Health Care Education/Training ProgramOH

General Provider Information

NPI Number : 1891646964
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA BOUMITRI
Provider Business Mailing Address
First Line : 2216 GREEN ACRES DR
Second Line :
City : PARMA
State : OH
Zip : 44134-6546
Country : US
Telephone Number : 440-864-8020
Fax Number :
Provider Business Practice Location Address
First Line : 11100 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1716
Country : US
Telephone Number : 877-357-8033
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/05/2026

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Directions to “ MELISSA BOUMITRI ” Practice Location

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