MEDICARE: MRS. JULIANA MELARA

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1831275387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIANA MELARA

Provider Business Mailing Address
First Line	:	700 W 23RD ST
Second Line	:	SUITE 100
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-3936
Country	:	US
Telephone Number	:	850-747-5411
Fax Number	:	850-747-5583

Provider Business Practice Location Address
First Line	:	700 W 23RD ST
Second Line	:	SUITE 100
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-3936
Country	:	US
Telephone Number	:	850-747-5411
Fax Number	:	850-747-5583

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

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	07/09/2007

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