Healthcare Provider Details

I. General information

NPI: 1932489473
Provider Name (Legal Business Name): WILLIAM Z MELVIN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2011
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2679 N ATLANTIC AVE
DAYTONA BEACH FL
32118-3205
US

IV. Provider business mailing address

17 STONEY RIDGE LN
ORMOND BEACH FL
32174-3072
US

V. Phone/Fax

Practice location:
  • Phone: 386-672-2008
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS43776
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License NumberTN34594
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: