MEDICARE: DR. MELISSA BLACKBURN DO

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	208000000X	Pediatrics Physician	OS17882	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609362755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELISSA BLACKBURN DO

Provider Business Mailing Address
First Line	:	1324 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-4543
Country	:	US
Telephone Number	:	863-687-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	430 E CENTRAL AVE
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33880-3050
Country	:	US
Telephone Number	:	863-284-5000
Fax Number	:

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

Provider Enumeration Date	:	07/02/2018
Last Update Date	:	03/02/2026

Similar Medicare Providers

1790005890 — DR. ALINA STANICA MD
Practice Location Address:

430 E CENTRAL AVE
WINTER HAVEN, FL
33880-3050

Practice Phone: 863-284-5000
Practice Fax:

1083618698 — RAUL ALVAREZ JR. M.D.
Practice Location Address:

430 E CENTRAL AVE
WINTER HAVEN, FL
33880-3050

Practice Phone: 863-284-6850
Practice Fax: 863-284-6853

1629073143 — ROMANA PETROVICH ARNP
Practice Location Address:

430 E CENTRAL AVE
WINTER HAVEN, FL
33880-3050

Practice Phone: 863-284-6850
Practice Fax: 863-284-6853

1740286277 — SUSAN SANDOVAL M.D.
Practice Location Address:

430 E CENTRAL AVE
WINTER HAVEN, FL
33880-3050

Practice Phone: 863-284-6850
Practice Fax: 863-284-6853

1407847585 — KEVIN L HENNE OD
Practice Location Address:

410 E CENTRAL AVE
WINTER HAVEN, FL
33880-3050

Practice Phone: 863-293-0276
Practice Fax: 863-299-3172

1083689160 — DR. MARIA ISABEL MARTINO-VILLANUEVA M.D.
Practice Location Address:

450 E CENTRAL AVE
WINTER HAVEN, FL
33880-3050

Practice Phone: 863-298-3204
Practice Fax: 863-298-3200

Directions to “ DR. MELISSA BLACKBURN DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.