Basic Information
| Provider Information | |||||||||
| NPI: | 1659393031 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EIRICH | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1021 N STATE ROAD 7 | ||||||||
| Address2: | MEDEXPRESS URGENT CARE | ||||||||
| City: | ROYAL PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334115117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613339331 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1021 N STATE ROAD 7 | ||||||||
| Address2: | MEDEXPRESS URGENT CARE | ||||||||
| City: | ROYAL PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334115117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613339331 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 09/11/2019 | ||||||||
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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 | 207P00000X | S2022 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207PE0004X | ME101416 | FL | N | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services | 207P00000X | ME101416 | FL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 203981 | NY | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 52240 | KY | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | E-12011 | AR | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 58757 | TN | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 312131 | LA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | G162220 | CA | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 01720841 | 05 | NY | MEDICAID |