Healthcare Provider Details

I. General information

NPI: 1760831994
Provider Name (Legal Business Name): MELISSA LOUISE FRENCH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA LOUISE CAROLLO

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 02/10/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7236 STONEROCK CIR
ORLANDO FL
32819-8000
US

IV. Provider business mailing address

7236 STONEROCK CIR
ORLANDO FL
32819-8000
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-6444
  • Fax: 407-650-1307
Mailing address:
  • Phone: 321-841-6444
  • Fax: 407-650-1307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number21190
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11008157
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: