Individual
COLLEEN MELLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6900 DANIELS PKWY STE 19, FORT MYERS, FL 33912-1586
(239) 768-2210
Mailing address
6900 DANIELS PKWY STE 19, FORT MYERS, FL 33912-1586
(239) 768-2210
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS52610
FL
Other
Enumeration date
02/10/2015
Last updated
02/10/2015
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