Provider Demographics
NPI:1023486552
Name:PERKINS, MELISSA (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:ZUNIGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7026 WOODCHASE GLEN DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-8401
Mailing Address - Country:US
Mailing Address - Phone:305-901-9309
Mailing Address - Fax:
Practice Address - Street 1:602 VONDERBURG DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511
Practice Address - Country:US
Practice Address - Phone:305-901-9309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-15
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA15007235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty