Healthcare Provider Details

I. General information

NPI: 1568372845
Provider Name (Legal Business Name): MELISSA JEAN STEPHENS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 MARBELLA LN APT 116
SANFORD FL
32771-0179
US

IV. Provider business mailing address

601 MARBELLA LN APT 116
SANFORD FL
32771-0179
US

V. Phone/Fax

Practice location:
  • Phone: 407-456-9300
  • Fax:
Mailing address:
  • Phone: 407-456-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: