MEDICARE: MS. MELANIE ROSARIO MURILLO

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1942955497
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELANIE ROSARIO MURILLO

Provider Business Mailing Address
First Line	:	1148 BELKTON AVE
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33948-6206
Country	:	US
Telephone Number	:	941-204-8406
Fax Number	:

Provider Business Practice Location Address
First Line	:	1148 BELKTON AVE
Second Line	:
City	:	PORT CHARLOTTE
State	:	FL
Zip	:	33948-6206
Country	:	US
Telephone Number	:	941-204-8406
Fax Number	:

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

Provider Enumeration Date	:	02/14/2022
Last Update Date	:	02/14/2022

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