Provider Demographics
NPI:1295773497
Name:GAD, MELISSA MILLER (ARNP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MILLER
Last Name:GAD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3320 OCEAN SHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32176
Mailing Address - Country:US
Mailing Address - Phone:337-233-2400
Mailing Address - Fax:337-232-3656
Practice Address - Street 1:208 BOOTH ROAD SUITE C
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32714
Practice Address - Country:US
Practice Address - Phone:386-256-4118
Practice Address - Fax:386-256-4303
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1428363LP0808X
FLARNP9355262363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health