MEDICARE: MELISSA ANN JOSEPH APRN

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	207Q00000X	Family Medicine Physician	11017195	FL
2	208VP0014X	Interventional Pain Medicine Physician	11017195	FL

General Provider Information

NPI Number	:	1326783192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ANN JOSEPH APRN

Provider Business Mailing Address
First Line	:	5217 FAIRWAY ONE DR
Second Line	:
City	:	VALRICO
State	:	FL
Zip	:	33596-8234
Country	:	US
Telephone Number	:	813-785-8170
Fax Number	:

Provider Business Practice Location Address
First Line	:	2727 W MLK BLVD STE 520
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-6000
Country	:	US
Telephone Number	:	813-538-7600
Fax Number	:

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

Provider Enumeration Date	:	05/04/2022
Last Update Date	:	11/15/2024

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Directions to “ MELISSA ANN JOSEPH APRN” Practice Location

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