Prutch, Melissa N
Prutch, Melissa N is an individual health care provider with primary practice located at 1005 Dale Mabry Hwy , Lutz FL 33548-3021. She recently has 5 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Sports Medicine, Podiatric Medicine & Surgery Service Providers / Foot Surgery, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is her primary health care specialty. Prutch, Melissa N can be contacted via phone (813) 549-5678.Contact Information
Primary practice address
1005 Dale Mabry Hwy
Lutz FL 33548-3021
Phone: (813) 549-5678
Fax: (813) 701-9132
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine | 213EP1101X | PO4507 | Florida |
| Podiatric Medicine & Surgery Service Providers / Sports Medicine | 213ES0000X | PO4507 | Florida |
| Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | PO4507 | Florida |
| Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery | 213ES0103X | PO4507 | Florida |
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | PO4507 | Florida |
Profile Details
| NPI number | 1164153706 |
|---|---|
| LBN Legal business name | Prutch, Melissa N |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 23rd, 2022 |
| Last updated | Jun 12th, 2024 - about 5 months ago |
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 | 1164153706 | NPPES |
| Florida | MEDICAID | 119076100 | |
| Florida | Other | 15584066 | |
| Florida | Other | 3AEL6 |
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