MEDICARE: MELANIE BU OD

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	152W00000X	Optometrist	OPC6477	FL

General Provider Information

NPI Number	:	1336911049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE BU OD

Provider Business Mailing Address
First Line	:	20001 NW 57TH CT
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-4954
Country	:	US
Telephone Number	:	786-499-3324
Fax Number	:

Provider Business Practice Location Address
First Line	:	8051 W 24TH AVE STE 13
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-5596
Country	:	US
Telephone Number	:	305-364-3737
Fax Number	:

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

Provider Enumeration Date	:	10/25/2023
Last Update Date	:	08/26/2025

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