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General NPI Number Information
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NPI Number | 1629628557
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Entity Type | Individual
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Provider Name | MELISSA LYNN DANIES PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/12/2019
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Last Update Date | 09/13/2022
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Provider Practice Location Address
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Address Line | 747 PONCE DE LEON BLVD STE 305
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City | CORAL GABLES
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State | FL
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Zip | 33134-2073
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Country | US
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Telephone | 305-444-4903
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Fax | 305-444-4913
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Provider Business Mailing Address
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Address Line | 15280 NW 79TH CT STE 200
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City | MIAMI LAKES
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State | FL
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Zip | 33016-5873
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Country | US
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Telephone | 305-558-3724
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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 | PA9115566
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License Number State | FL
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