Individual
MELISSA L. KINGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 W GORE ST STE 403, ORLANDO, FL 32806-1049
(321) 841-3050
(321) 843-3570
Mailing address
100 W GORE ST STE 403, ORLANDO, FL 32806-1049
(321) 841-3050
(321) 843-3570
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
AZ
363AS0400X
Surgical Physician Assistant
Primary
PA9119140
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124034000
—
FL
Enumeration date
09/25/2017
Last updated
11/18/2024
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