Healthcare Provider Details

I. General information

NPI: 1508881467
Provider Name (Legal Business Name): MELODY NOEL BAADE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELODY N MERRELL MD

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 CROSSINGS BLVD UNIT 100
ODESSA FL
33556-6106
US

IV. Provider business mailing address

4033 TAMPA RD STE 101
OLDSMAR FL
34677-3224
US

V. Phone/Fax

Practice location:
  • Phone: 813-475-7100
  • Fax: 813-475-7119
Mailing address:
  • Phone: 813-854-2003
  • Fax: 813-855-2367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME0049336
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: