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General NPI Number Information
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NPI Number | 1790696003
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Entity Type | Individual
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Provider Name | MELISSA HEBEIN
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Gender |
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 5245 BABCOCK ST NE
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City | PALM BAY
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State | FL
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Zip | 32905-4601
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Country | US
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Telephone | 321-409-1148
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3666
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City | KETCHUM
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State | ID
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Zip | 83340-3500
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 3471066
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 70070
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License Number State | FL
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