Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 0062584 | FL |
Y | 363L00000X | Nurse Practitioner | ARNP3301392 | FL |
NPI | 1215921366 |
---|---|
Provider Name | Mrs. Melissa R Autieri |
First Address | Clearwater, FL 33756 |
Second Address | Clearwater, FL 33756 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2005 |
Last Update Date | 01/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
304126300 | (05) | FL |
P45108 | (02) | |
P45108 | (02) | FL |