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Individual
MELISSA MAXWELL
Active
Individual
MELISSA MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT22989
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58-1375201
TRICARE GROUP
GA
01
—
650020377
RAILROAD MEDICARE GROUP
GA
01
—
820717
BLUE CROSS BLUE SHIELD
GA
01
—
CL3489
RAILROAD MEDICARE
GA
01
—
GRP3435
MEDICARE GROUP NUMBER
GA
Enumeration date
11/11/2005
Last updated
11/29/2023
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