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NPI Code Detail

MEDICARE: MARY FRANCES MELVILLE PA-C

MEDICARE: MARY FRANCES MELVILLE PA-C
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
1363A00000XPhysician AssistantPA9101313FL

General Provider Information

NPI Number : 1962537605
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY FRANCES MELVILLE PA-C
Provider Business Mailing Address
First Line : PO BOX 746638
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6638
Country : US
Telephone Number : 904-202-1032
Fax Number : 904-376-4107
Provider Business Practice Location Address
First Line : 10337 SAN JOSE BLVD STE 200
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32257-8223
Country : US
Telephone Number : 904-260-3200
Fax Number : 904-390-7506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2007
Last Update Date : 12/12/2022

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Directions to “ MARY FRANCES MELVILLE PA-C” Practice Location

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