Mela, Jac-Lyn

Mela, Jac-Lyn is an individual health care provider with primary practice located at 880 6Th St S Ste 320 , St Petersburg FL 33701-4824. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Mela, Jac-Lyn can be contacted via phone (727) 767-8590.

Contact Information

Primary practice address
880 6Th St S Ste 320 St Petersburg FL 33701-4824
Phone: (727) 767-8590
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA9107044 Florida

Profile Details

NPI number 1578808945
LBN Legal business name Mela, Jac-Lyn
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 11th, 2012
Last updated Feb 28th, 2024 - about 2 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 1578808945 NPPES
Florida MEDICAID 0081289-00

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