Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | ME0065024 | FL |
NPI | 1063480085 |
---|---|
Provider Name | Marc A Melser |
First Address | Fort Myers, FL 33907-1412 |
Second Address | Port Charlotte, FL 33952-8127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 18/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1193401 | WELLCARE (01) | FL |
25222 | BC/BS FL (01) | FL |
334857 | AVMED (01) | FL |
375845100 | (05) | FL |
5496020 | AETNA (01) | FL |
E50733 | (02) | FL |
P00699994 | RAILROAD MEDICARE (01) | FL |
QMP000005122202 | MOLINA HEALTHCARE (01) | FL |