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General NPI Number Information
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NPI Number | 1538920863
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Entity Type | Individual
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Provider Name | MELISSA SARAH WALKER PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/23/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 1100 NW 95TH ST
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City | MIAMI
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State | FL
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Zip | 33150-2038
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Country | US
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Telephone | 305-835-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 12905 SW 31ST CT
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City | MIRAMAR
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State | FL
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Zip | 33027-5336
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 9118537
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9118537
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License Number State | FL
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