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NPI Code Detail

MEDICARE: MELISSA J AVERILL

MEDICARE: MELISSA J AVERILL
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
1106S00000XBehavior TechnicianB14575833AZ

General Provider Information

NPI Number : 1972453520
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA J AVERILL
Provider Business Mailing Address
First Line : 996 ROYAL MARCO WAY
Second Line :
City : MARCO ISLAND
State : FL
Zip : 34145-1829
Country : US
Telephone Number : 310-699-4229
Fax Number :
Provider Business Practice Location Address
First Line : 996 ROYAL MARCO WAY
Second Line :
City : MARCO ISLAND
State : FL
Zip : 34145-1829
Country : US
Telephone Number : 310-699-4229
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “ MELISSA J AVERILL ” Practice Location

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