Melton, Jeremiah J
Melton, Jeremiah J is an individual health care provider with primary practice located at 1000 36Th St , Vero Beach FL 32960-4862. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Melton, Jeremiah J can be contacted via phone (772) 563-4580.Contact Information
Primary practice address
1000 36Th St
Vero Beach FL 32960-4862
Phone: (772) 563-4580
Fax: (772) 563-4690
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 2003025135 | Missouri |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA9117544 | Florida |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 2003025135 | Missouri |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 1500902 | Kansas |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 1500902 | Kansas |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 2003025135 | Missouri |
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | PA9117544 | Florida |
Profile Details
| NPI number | 1366524134 |
|---|---|
| LBN Legal business name | Melton, Jeremiah J |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 20th, 2006 |
| Last updated | Aug 1st, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366524134 | NPPES |
| Missouri | MEDICAID | 220040523 | |
| Missouri | MEDICAID | 200001350H |
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