Individual
MELISHA JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
2789 ORTIZ AVE, FORT MYERS, FL 33905-7806
(239) 791-1586
(239) 278-9058
Mailing address
2789 ORTIZ AVE, FORT MYERS, FL 33905-7806
(239) 791-1586
(239) 278-9058
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
J210-540-89-551-0
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J210-540-89-551-0
DRIVERS LICENSE
FL
Enumeration date
11/28/2012
Last updated
11/28/2012
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