Provider Information for 1700357985
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MELISSA BODE MA
Sex: Female
NPI: 1700357985
Last Updated: 2018-12-16
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1700357985 | ||||||||
| Enumeration Date | 2018-12-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1002 N SEMORAN BLVD ORLANDO, FL 32807-3531 United States Phone: 407-275-8939 | Fax: | ||||||||
| Primary Practice Address | 1002 N SEMORAN BLVD ORLANDO, FL 32807-3531 United States Phone: 407-275-8939 | Fax:407-282-3674 | ||||||||
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