Individual
MELODY O. KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8745 N WICKHAM RD, MELBOURNE, FL 32940-5997
(321) 434-9358
(321) 434-9521
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-9358
(321) 434-9521
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2008-01911
NC
208M00000X
Hospitalist Physician
Primary
ME110293
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003693100
—
FL
01
—
14E6C
FLORIDA BLUE
FL
01
—
9877194
AETNA PROVIDER #
—
01
—
FC018Y
MEDICARE
FL
01
—
P01275461
RRMR
FL
Enumeration date
08/09/2006
Last updated
04/04/2019
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