Provider Demographics
NPI:1730439803
Name:VEAUDRY-MARTIN, MELISSA LEANNE (AP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:LEANNE
Last Name:VEAUDRY-MARTIN
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 BETHAWAY AVENUE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806
Mailing Address - Country:US
Mailing Address - Phone:407-222-5373
Mailing Address - Fax:
Practice Address - Street 1:871 VINELAND RD
Practice Address - Street 2:B
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3938
Practice Address - Country:US
Practice Address - Phone:407-654-8700
Practice Address - Fax:407-654-7540
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1838171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist