Basic Information
Provider Information
NPI: 1548691223
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOWES
FirstName: MELISSA
MiddleName: ANNE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MATHIS
OtherFirstName: MELISSA
OtherMiddleName: ANNE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 25317
Address2:  
City: TAMPA
State: FL
PostalCode: 336225317
CountryCode: US
TelephoneNumber: 8132860033
FaxNumber: 8132821806
Practice Location
Address1: 5002 W LEMON ST
Address2:  
City: TAMPA
State: FL
PostalCode: 336091104
CountryCode: US
TelephoneNumber: 8132860033
FaxNumber: 8132821806
Other Information
ProviderEnumerationDate: 12/06/2013
LastUpdateDate: 10/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000XAPRN9227131FLY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

ID Information
IDTypeStateIssuerDescription
LM37301FLMEDICAREOTHER


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