| Medi Melbourne Llc | |
|
7630 N Wickham Rd Suite 104 Melbourne FL 32940-8257 | |
| (321) 610-7982 | |
| Not Available |
| Full Name | Medi Melbourne Llc |
|---|---|
| Speciality | General Practice |
| Location | 7630 N Wickham Rd, Melbourne, Florida |
| Authorized Official Name and Position | Thomas K Willett (MANAGING MEMBER) |
| Authorized Official Contact | 8132455305 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medi Melbourne Llc 412 E Madison St Suite 1100 Tampa FL 33602-4601 Ph: () - | Medi Melbourne Llc 7630 N Wickham Rd Suite 104 Melbourne FL 32940-8257 Ph: (321) 610-7982 |
| NPI Number | 1700256450 |
|---|---|
| Provider Enumeration Date | 10/06/2015 |
| Last Update Date | 10/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700256450 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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