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General NPI Number Information
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NPI Number | 1073900668
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Entity Type | Individual
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Provider Name | JUSTIN MELIA DC
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Gender | Male
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Dates
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Enumeration Date | 04/21/2015
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Last Update Date | 10/27/2021
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Provider Practice Location Address
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Address Line | 1770 SAN MARCO RD STE 203
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City | MARCO ISLAND
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State | FL
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Zip | 34145-5138
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Country | US
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Telephone | 239-970-2211
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Fax |
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Provider Business Mailing Address
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Address Line | 1770 SAN MARCO RD STE 203
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City | MARCO ISLAND
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State | FL
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Zip | 34145-5138
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Country | US
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Telephone | 908-454-2666
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Fax | 908-454-3315
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH13470
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License Number State | FL
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