Provider Demographics
NPI:1447346184
Name:DIPAOLIS, MELISSA LANI OHANA (ARNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LANI OHANA
Last Name:DIPAOLIS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:LANI OHANA
Other - Last Name:BEAULIEU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:85 E MITCHELL HAMMOCK RD
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9780
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:85 E MITCHELL HAMMOCK RD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9780
Practice Address - Country:US
Practice Address - Phone:855-925-4733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9170998363LA2200X, 363LP0200X, 363LP2300X, 363LW0102X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9170998OtherFL ARNP LICENSE