Koback, Melody

Koback, Melody is an individual health care provider with primary practice located at 2160 Howland Blvd Ste 110 , Deltona FL 32738-3468. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Koback, Melody can be contacted via phone (386) 532-0515.

Contact Information

Primary practice address
2160 Howland Blvd Ste 110 Deltona FL 32738-3468
Phone: (386) 532-0515
Fax: (386) 532-0516
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN11002961 Florida

Profile Details

NPI number 1952802043
LBN Legal business name Koback, Melody
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2018
Last updated Jan 5th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952802043 NPPES
Florida MEDICAID 103491600

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