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Individual

MR. IVAN DARIO MELNIKOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OT/L

Contact information

Practice address
1611 NW 12TH AVENUE, OCCUPATIONAL THARAPY DEPARTMENT, MIAMI, FL 33136-1096
(305) 585-7224
Mailing address
100 CORNERSTONE DR, CARY, NC 27519-8453
(919) 460-1921
(919) 460-1929

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13177
NC
225X00000X
Occupational Therapist
OT8407
FL

Other

Enumeration date
10/16/2006
Last updated
04/27/2021
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