Healthcare Provider Details

I. General information

NPI: 1932041019
Provider Name (Legal Business Name): MELISHA JAGAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

596 COURTLAND BLVD
DELTONA FL
32738-8902
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 407-249-1234
  • Fax: 407-249-1755
Mailing address:
  • Phone: 954-967-6400
  • Fax: 954-965-7339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11043424
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11043424
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: