=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386637916
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELISSA T ASUNCION MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2005
-----------------------------------------------------
Last Update Date | 01/05/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7258 SYLVAN GLADE CT
-----------------------------------------------------
City | WEEKI WACHEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34607-4002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-277-9287
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7258 SYLVAN GLADE CT
-----------------------------------------------------
City | WEEKI WACHEE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34607-4002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-277-9287
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QA0505X
-----------------------------------------------------
Taxonomy Name | Adult Medicine Physician
-----------------------------------------------------
License Number | ME87215
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------