Healthcare Provider Details

I. General information

NPI: 1346756921
Provider Name (Legal Business Name): MELISSA MARIE JALIL APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2017
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8765 S DIXIE HWY
PINECREST FL
33156-1111
US

IV. Provider business mailing address

8765 S DIXIE HWY
PINECREST FL
33156-1111
US

V. Phone/Fax

Practice location:
  • Phone: 305-740-6840
  • Fax: 305-740-5438
Mailing address:
  • Phone: 305-740-6840
  • Fax: 305-740-5438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9362865
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: