Healthcare Provider Details

I. General information

NPI: 1306580246
Provider Name (Legal Business Name): MELISSA TINHINEN MESSALTI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2022
Last Update Date: 05/04/2025
Certification Date: 05/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 CHILDRENS WAY
JACKSONVILLE FL
32207-8426
US

IV. Provider business mailing address

9012 NELSON WAY
COLUMBIA MD
21045-5148
US

V. Phone/Fax

Practice location:
  • Phone: 904-697-3942
  • Fax:
Mailing address:
  • Phone: 862-243-0257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number390200000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: