Provider Demographics
NPI:1235974569
Name:LLANES MORELL, MELBY (DMD)
Entity type:Individual
Prefix:DR
First Name:MELBY
Middle Name:
Last Name:LLANES MORELL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5796 S UNIVERSITY DR STE 102
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-6119
Mailing Address - Country:US
Mailing Address - Phone:954-248-2742
Mailing Address - Fax:
Practice Address - Street 1:5796 S UNIVERSITY DR STE 102
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-6119
Practice Address - Country:US
Practice Address - Phone:954-248-2742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29270122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist