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General NPI Number Information
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NPI Number | 1083195697
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Entity Type | Individual
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Provider Name | MELISSA THERESE HAUTEA PARAGAS OD
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Gender | Female
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 2181 ORANGE AVE E
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City | TALLAHASSEE
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State | FL
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Zip | 32311-6144
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Country | US
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Telephone | 510-931-8755
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Fax |
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Provider Business Mailing Address
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Address Line | 2839 SWEET RIDGE ST
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City | TALLAHASSEE
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State | FL
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Zip | 32308-4798
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Country | US
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Telephone |
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 34072TLG
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License Number State | CA
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