Melissa Devincentis
Physician Assistant, Medical in Fort Lauderdale, FL. Individual provider (NPI-1).
NPI number1154967115
StatusActive
Last updated in NPPESAug 2, 2021
Details
- NPI
- 1154967115
- Entity type
- Individual (NPI-1)
- Name
- Ms. Melissa Devincentis
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 25, 2019
- Certification date
- Aug 2, 2021
- Last updated
- Aug 2, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | – | – | Yes |
| 363AS0400X | Physician Assistant, Surgical | – | – |
Practice location
4725 N Federal HwyFort Lauderdale, FL 33308-4603
Phone 954-771-8000
Mailing address
2101 Ne 56th CtFort Lauderdale, FL 33308-2502
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