Healthcare Provider Details

I. General information

NPI: 1811680176
Provider Name (Legal Business Name): MELISSA OPIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2023
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5028 SILVER CHARM TER
WESLEY CHAPEL FL
33544-1582
US

IV. Provider business mailing address

5028 SILVER CHARM TER
WESLEY CHAPEL FL
33544-1582
US

V. Phone/Fax

Practice location:
  • Phone: 908-938-1577
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: