Healthcare Provider Details

I. General information

NPI: 1952098527
Provider Name (Legal Business Name): QUITA MELISSA GRIFFITH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2023
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1663 GEORGIA ST NE STE 500
PALM BAY FL
32907-2589
US

IV. Provider business mailing address

14103 ARTESIA DR SW
PORT SAINT LUCIE FL
34987-6340
US

V. Phone/Fax

Practice location:
  • Phone: 321-802-9080
  • Fax:
Mailing address:
  • Phone: 305-561-3605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9119205
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: