Individual
MELANIE DIANA ELMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2442 BLOOMINGDALE AVE, VALRICO, FL 33596-6403
(813) 586-8686
Mailing address
4321 SUNRISE DR S, ST PETERSBURG, FL 33705-4521
(919) 610-2765
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9109652
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019933000
—
FL
01
—
P00126770
RAILROAD MEDICARE
—
Enumeration date
04/07/2006
Last updated
06/05/2025
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