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NPI Code Detail

MEDICARE: RICKY MELENDY PTA

MEDICARE:   RICKY  MELENDY  PTA
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
1225200000XPhysical Therapy AssistantPTA21829FL

General Provider Information

NPI Number : 1164793220
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICKY MELENDY PTA
Provider Business Mailing Address
First Line : 2420 SHEFFIELD AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32806-6502
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15204 W COLONIAL DR
Second Line :
City : WINTER GARDEN
State : FL
Zip : 34787-6042
Country : US
Telephone Number : 407-877-2394
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2012
Last Update Date : 01/21/2012

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Directions to “ RICKY MELENDY PTA” Practice Location

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