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Poonam Mishra, DO
Adult Medicine Physician in Melbourne, Florida
NPI 1306836952

Poonam Mishra is an Adult Medicine Physician based in Melbourne, FL and is specialized in Adult Medicine. Poonam Mishra practices in Melbourne, FL and has the professional credentials of DO. The NPI Number for Poonam Mishra is 1306836952 and holds a License No. 593360315 (Florida).

The current practice location address for Poonam Mishra is 401 N Wickham Rd, Melbourne, FL and can be reached out via phone at 321-757-5105 and via fax at 321-757-5104.

Location: 401 N Wickham Rd, Melbourne, FL, 32935-8659
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1306836952
Provider Name
Poonam Mishra
Credential
DO
Provider Entity Type
Individual
Gender
Female
Address
401 N Wickham Rd, Melbourne, FL, 32935-8659
Phone Number
321-757-5105
Fax Number
321-757-5104
Provider Enumeration Date
10/25/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
40462 01 FL BCBS MAB GROUP
57174 01 FL BCBS PROVIDER ID
institution
Provider Business Practice Location Address Details
Address
401 N Wickham Rd
City
Melbourne
State
Florida
Zip
32935-8659
Phone Number
321-757-5105
Fax Number
321-757-5104
person
Provider Business Mailing Address Details
Address
401 N Wickham Rd
City
Melbourne
State
Florida
Zip
32935-8659
Phone Number
321-757-5105
Fax Number
321-757-5104
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adult Medicine
Taxonomy
207QA0505X
License No.
593360315 (Florida)
Definition
Definition to come.
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