Provider Demographics
NPI:1609072933
Name:WAHL, MELANIE JANETTE (MD)
Entity type:Individual
Prefix:DR
First Name:MELANIE
Middle Name:JANETTE
Last Name:WAHL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:JANETTE
Other - Last Name:BALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:938 CYPRESS VILLAGE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-6835
Mailing Address - Country:US
Mailing Address - Phone:813-333-5080
Mailing Address - Fax:813-773-7717
Practice Address - Street 1:6310 HEALTH PARK WAY STE 130
Practice Address - Street 2:
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-5177
Practice Address - Country:US
Practice Address - Phone:813-333-5080
Practice Address - Fax:813-773-7717
Is Sole Proprietor?:No
Enumeration Date:2007-06-24
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME176113207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP00878235OtherRAILROAD MEDICARE
MOP00878235OtherRAILROAD MEDICARE
MOP00878235OtherRAILROAD MEDICARE
MO1609072933Medicaid