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General NPI Number Information
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NPI Number | 1114103058
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Entity Type | Organization
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Legal Business Name | MELISSA ANN DEAN MD PL
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 11/14/2012
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Provider Practice Location Address
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Address Line | 1345 36TH ST SUITE B
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City | VERO BEACH
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State | FL
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Zip | 32960-4811
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Country | US
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Telephone | 772-567-1500
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Fax | 772-567-1505
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Provider Business Mailing Address
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Address Line | 1345 36TH ST SUITE B
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City | VERO BEACH
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State | FL
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Zip | 32960-4811
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Country | US
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Telephone | 772-567-1500
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Fax | 772-567-1505
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. MELISSA ANN DEAN
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Credential | MD
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Telephone | 772-584-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME98123
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License Number State | FL
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