Individual
JAC-LYN MELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
880 6TH ST S STE 320, ST PETERSBURG, FL 33701-4824
(727) 767-8590
Mailing address
880 6TH ST S STE 320, ST PETERSBURG, FL 33701-4824
(727) 767-8590
(727) 767-4319
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9107044
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0081289-00
—
FL
Enumeration date
12/11/2012
Last updated
02/28/2024
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