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NPI Code Detail

MEDICARE: PATRICIA DE MELLO MD

MEDICARE: PATRICIA DE MELLO MD
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
1207Q00000XFamily Medicine Physician15295PR
2208D00000XGeneral Practice PhysicianACN1048FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942303995
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA DE MELLO MD
Provider Business Mailing Address
First Line : 110 S WOODLAND ST
Second Line :
City : WINTER GARDEN
State : FL
Zip : 34787-3546
Country : US
Telephone Number : 407-905-8827
Fax Number : 321-221-9454
Provider Business Practice Location Address
First Line : 849 GREENWAY PROFESSIONAL CT
Second Line :
City : ORLANDO
State : FL
Zip : 32824-9482
Country : US
Telephone Number : 407-905-8827
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2006
Last Update Date : 05/14/2025

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Directions to “ PATRICIA DE MELLO MD” Practice Location

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