Provider Demographics
NPI:1447234646
Name:HAYES, MELINDA H (MD)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:H
Last Name:HAYES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2914 N BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-1208
Mailing Address - Country:US
Mailing Address - Phone:813-228-7696
Mailing Address - Fax:813-228-0677
Practice Address - Street 1:2914 N BOULEVARD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-1208
Practice Address - Country:US
Practice Address - Phone:813-228-7696
Practice Address - Fax:813-228-0677
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90112208100000X
FLME00901122081N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7647549OtherAETNA
FL269547200Medicaid
59171265OtherBSAL
FL37998OtherBSFL
59171265OtherBSAL
FL269547200Medicaid