Individual
MELISENT DIANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
832 W CENTRAL BLVD, ORLANDO, FL 32805-1809
(407) 836-9280
(407) 836-2522
Mailing address
6101 LAKE ELLENOR DR, ORLANDO, FL 32809-4616
(407) 858-1400
(407) 858-5523
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019460500
—
FL
Enumeration date
04/05/2017
Last updated
05/03/2017
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