MEDICARE: MRS. EVELYN MELO LMHC

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	MH6858	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1972738854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EVELYN MELO LMHC

Provider Business Mailing Address
First Line	:	8785 SW 165TH AVE
Second Line	:	SUITE #200
City	:	MIAMI
State	:	FL
Zip	:	33193-5826
Country	:	US
Telephone Number	:	786-587-9656
Fax Number	:

Provider Business Practice Location Address
First Line	:	8785 SW 165TH AVE
Second Line	:	SUITE # 200
City	:	MIAMI
State	:	FL
Zip	:	33193-5826
Country	:	US
Telephone Number	:	786-587-9656
Fax Number	:

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

Provider Enumeration Date	:	05/21/2009
Last Update Date	:	03/18/2014

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