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Individual

MR. HERMANN J MELLON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
315 W 9TH ST, 2ND FLOOR, HIALEAH, FL 33010-3853
(786) 360-4528
(786) 360-4529
Mailing address
PO BOX 480389, FT LAUDERDALE, FL 33348-0389
(561) 672-7851
(561) 672-7861

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME69649
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
259474900
FL
Enumeration date
09/20/2007
Last updated
02/07/2012
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