Individual
MS. CAROL MILLER MELLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,RD,LD
Contact information
Practice address
1717 S ORANGE AVE, ORLANDO, FL 32806-2944
(407) 650-7000
(407) 567-5924
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND 3560
FL
Other
Enumeration date
05/21/2009
Last updated
07/15/2014
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