MEDICARE: MELISSA FLOR PEREZ QUINTANA

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	171M00000X	Case Manager/Care Coordinator	CBHCM.0107870-P	FL

General Provider Information

NPI Number	:	1679430797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA FLOR PEREZ QUINTANA

Provider Business Mailing Address
First Line	:	716 CALVIN AVE
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33972-7615
Country	:	US
Telephone Number	:	239-391-1195
Fax Number	:

Provider Business Practice Location Address
First Line	:	716 CALVIN AVE
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33972-7615
Country	:	US
Telephone Number	:	239-391-1195
Fax Number	:

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

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/09/2026

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