Individual
CHANDLER MELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1865 LPGA BLVD, DAYTONA BEACH, FL 32117-7108
(386) 255-4596
(386) 258-3561
Mailing address
1865 LPGA BLVD, DAYTONA BEACH, FL 32117-7108
(386) 255-4596
(386) 258-3561
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9111941
FL
363AS0400X
Surgical Physician Assistant
PA9111941
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102217800
—
FL
01
—
PA9111941
DEPARTMENT OF HEALTH
FL
Enumeration date
01/14/2019
Last updated
07/31/2024
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