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NPI Code Detail

MEDICARE: SHAWNA NICOLE MELVILLE PA-C

MEDICARE: SHAWNA NICOLE MELVILLE PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1750923272
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWNA NICOLE MELVILLE PA-C
Provider Business Mailing Address
First Line : 6675 WESTWOOD BLVD STE 475
Second Line :
City : ORLANDO
State : FL
Zip : 32821-6027
Country : US
Telephone Number : 407-845-0330
Fax Number :
Provider Business Practice Location Address
First Line : 4729 US HIGHWAY 98 S STE 201
Second Line :
City : LAKELAND
State : FL
Zip : 33812-4336
Country : US
Telephone Number : 863-646-9663
Fax Number : 863-364-6966
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2019
Last Update Date : 03/31/2025

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Directions to “ SHAWNA NICOLE MELVILLE PA-C” Practice Location

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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.

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