MEDICARE: MELIA GRAFF DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	30689	FL

General Provider Information

NPI Number	:	1073999652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELIA GRAFF DPT

Provider Business Mailing Address
First Line	:	5118 PARK ST
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32404-6716
Country	:	US
Telephone Number	:	850-890-8535
Fax Number	:

Provider Business Practice Location Address
First Line	:	10800 PANAMA CITY BEACH PKWY
Second Line	:	SUITE 100
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32407-2533
Country	:	US
Telephone Number	:	850-588-6852
Fax Number	:	850-588-6847

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2015
Last Update Date	:	08/05/2015

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