Healthcare Provider Details

I. General information

NPI: 1134063324
Provider Name (Legal Business Name): MELISSA MEISINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 EASTWEST PKWY STE 3
FLEMING ISLAND FL
32003-5310
US

IV. Provider business mailing address

3410 GATOR BAY RD
GREEN COVE SPRINGS FL
32043-4544
US

V. Phone/Fax

Practice location:
  • Phone: 904-264-3770
  • Fax:
Mailing address:
  • Phone: 904-264-3770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA89606
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: