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General NPI Number Information
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NPI Number | 1487996625
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Entity Type | Individual
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Provider Name | MELISSA SHANNON DUBOIS NP-C
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Gender | Female
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 3609 MADACA LN
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City | TAMPA
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State | FL
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Zip | 33618-2048
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Country | US
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Telephone | 720-253-3071
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Fax |
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Provider Business Mailing Address
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Address Line | 3820 NORTHDALE BLVD STE 201
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City | TAMPA
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State | FL
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Zip | 33624-1893
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Country | US
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Telephone | 800-991-6117
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 9439368
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 9439368
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | 9439368
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License Number State | FL
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