Healthcare Provider Details

I. General information

NPI: 1922014547
Provider Name (Legal Business Name): JOSE B. MELO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOSE B. DE MELO FILHO M.D.

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 04/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 W SUNRISE BLVD BLDG C
PLANTATION FL
33322-5426
US

IV. Provider business mailing address

7351 W OAKLAND PARK BLVD SUITE 106
TAMARAC FL
33319-7107
US

V. Phone/Fax

Practice location:
  • Phone: 954-370-8585
  • Fax: 954-370-1585
Mailing address:
  • Phone: 954-749-6955
  • Fax: 954-578-2783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberME0042914
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: