Healthcare Provider Details

I. General information

NPI: 1508920026
Provider Name (Legal Business Name): MELISSA D KOLIHA PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA D BURKE PA

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10590 N MERIDIAN ST # 105
CARMEL IN
46290-1028
US

IV. Provider business mailing address

1345 W BAY DR STE 301
LARGO FL
33770-2264
US

V. Phone/Fax

Practice location:
  • Phone: 317-583-7800
  • Fax: 317-583-7818
Mailing address:
  • Phone: 727-587-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number10004766A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA 9103235
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: