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General NPI Number Information
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NPI Number | 1740001312
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Entity Type | Individual
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Provider Name | ROBERT MELTON L.D.O
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Gender |
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Dates
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Enumeration Date | 10/17/2024
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 1239 STATE ROAD 436 STE 101
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City | CASSELBERRY
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State | FL
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Zip | 32707-6447
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Country | US
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Telephone | 407-677-7813
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Fax | 407-677-9364
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Provider Business Mailing Address
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Address Line | 1239 STATE ROAD 436 STE 101
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City | CASSELBERRY
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State | FL
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Zip | 32707-6447
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Country | US
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Telephone | 407-677-7813
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Fax | 407-677-9364
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | DO5170
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License Number State | FL
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