MEDICARE: NASHALI MARIE MELENDEZ

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	390200000X	Student in an Organized Health Care Education/Training Program
2	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1134614670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NASHALI MARIE MELENDEZ

Provider Business Mailing Address
First Line	:	2253 WYNDHAM PALMS WAY
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34747-2781
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1925 OCOEE CROWN POINT PKWY
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-5060
Country	:	US
Telephone Number	:	407-905-3000
Fax Number	:

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

Provider Enumeration Date	:	06/27/2018
Last Update Date	:	03/27/2026

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