Individual
MELBA MERCED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4616 N LINCOLN AVE, TAMPA, FL 33614-6634
(403) 516-4399
Mailing address
PO BOX 273372, TAMPA, FL 33688-3372
(813) 516-4399
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015674300
—
FL
Enumeration date
09/16/2016
Last updated
09/16/2016
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