Healthcare Provider Details

I. General information

NPI: 1730259169
Provider Name (Legal Business Name): MELISSA PEDRAZZANI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 WINTER GARDEN VINELAND RD
WINDERMERE FL
34786-6098
US

IV. Provider business mailing address

5151 WINTER GARDEN VINELAND RD
WINDERMERE FL
34786-6098
US

V. Phone/Fax

Practice location:
  • Phone: 407-298-6950
  • Fax: 321-843-6316
Mailing address:
  • Phone: 407-648-3800
  • Fax: 407-425-5203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9101119
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: