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General NPI Number Information
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NPI Number | 1427585751
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Entity Type | Individual
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Provider Name | MELANIE MASON RN
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Gender | Female
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Dates
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Enumeration Date | 05/17/2017
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 3074 W LAKE MARY BLVD STE 132
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City | LAKE MARY
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State | FL
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Zip | 32746-6749
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Country | US
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Telephone | 407-917-0322
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Fax |
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Provider Business Mailing Address
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Address Line | 3715 N BUSINESS DR STE 202
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5288
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT3456
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9305106
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License Number State | FL
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