MEDICARE: MRS. MELISSA ANNE AMAYA LCSW

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	1041C0700X	Clinical Social Worker	SW8116	FL

General Provider Information

NPI Number	:	1780860577
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELISSA ANNE AMAYA LCSW

Provider Business Mailing Address
First Line	:	20026 HERITAGE POINT DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3343
Country	:	US
Telephone Number	:	813-973-4591
Fax Number	:

Provider Business Practice Location Address
First Line	:	20026 HERITAGE POINT DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3343
Country	:	US
Telephone Number	:	813-973-4591
Fax Number	:

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

Provider Enumeration Date	:	01/11/2008
Last Update Date	:	01/11/2008

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