MEDICARE: MELISSA ANISKEWICZ

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	163W00000X	Registered Nurse	RN9277320	FL
2	367500000X	Certified Registered Nurse Anesthetist	APRN11016266	FL

General Provider Information

NPI Number	:	1912533357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ANISKEWICZ

Provider Business Mailing Address
First Line	:	16974 TOLEDO BLADE BLVD
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33954-1674
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	21298 OLEAN BLVD
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33952-6765
Country	:	US
Telephone Number	:	941-268-5110
Fax Number	:

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

Provider Enumeration Date	:	03/17/2020
Last Update Date	:	11/16/2021

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Directions to “ MELISSA ANISKEWICZ ” Practice Location

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