Individual
JEREMIAH J MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1000 36TH ST, VERO BEACH, FL 32960-4862
(772) 563-4580
(772) 563-4690
Mailing address
1000 36TH ST, VERO BEACH, FL 32960-4862
(772) 563-4580
(772) 563-4690
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
2003025135
MO
363A00000X
Physician Assistant
PA9117544
FL
363AM0700X
Medical Physician Assistant
1500902
KS
363AM0700X
Medical Physician Assistant
2003025135
MO
363AS0400X
Surgical Physician Assistant
1500902
KS
363AS0400X
Surgical Physician Assistant
2003025135
MO
363AS0400X
Surgical Physician Assistant
Primary
PA9117544
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200001350H
—
KS
05
—
220040523
—
MO
Enumeration date
10/20/2006
Last updated
08/01/2023
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