Doctor Name: | MS. MELISSA BARDACHINO |
NPI Number: | 1285908574 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT |
License Number: | MA45875 |
Business Practice Address: | 8109 Cooper Creek Blvd University Park, FL - 342012004 |
Business Phone Number: | 9413661168 |
Business Fax Number: | |
Mailing Address: | 5552 Bentgrass Dr, Unit 109 SARASOTA |
State: | FL |
Postal Code: | 342352688 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/04/2012 |
NPI Last Update Date: | 03/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA45875 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |