Healthcare Provider Details

I. General information

NPI: 1184367047
Provider Name (Legal Business Name): MELISSA MARIA PEDROSO MOREJON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 W 60TH ST APT 5
HIALEAH FL
33012-6817
US

IV. Provider business mailing address

1660 W 60TH ST APT 5
HIALEAH FL
33012-6817
US

V. Phone/Fax

Practice location:
  • Phone: 786-370-3513
  • Fax:
Mailing address:
  • Phone: 786-370-3513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-2835300
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: