Basic Information
| Provider Information | |||||||||
| NPI: | 1649500976 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MARCHAND | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | NOELLE | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5850 CORAL RIDGE DRIVE | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330761617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547142800 | ||||||||
| FaxNumber: | 9548402626 | ||||||||
| Practice Location | |||||||||
| Address1: | 5850 CORAL RIDGE DRIVE | ||||||||
| Address2: | SUITE 106 | ||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330761617 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9547142800 | ||||||||
| FaxNumber: | 9548402626 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2010 | ||||||||
| LastUpdateDate: | 11/03/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA9104896 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.