Individual provider Active NPI

Melissa Shirazi, RN, IBCLC

  • Lactation Consultant (Non-RN)
  • Melbourne, FL
National Provider Identifier
1679308100
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
L311641 Issued in FL
Practice address
2903 Centrum PL
Melbourne, FL 32940-7355
Phone
(321) 831-6232
NPI assigned
Sep 4, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN9561021 FL
Lactation Consultant (Non-RN) 174N00000X L311641 FL Primary

Addresses

Primary practice location

2903 Centrum PL
Melbourne, FL 32940-7355

Mailing address

2903 Centrum PL
Melbourne, FL 32940-7355
Phone (321) 831-6232

Other names 1

  • Melissa Ancona Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9561021FLMDRegistered Nurse
L311641FLMDLactation Consultant (Non-RN)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1679308100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 CENTRUM PL",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407355",
            "telephone_number": "321-831-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2903 CENTRUM PL",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407355",
            "telephone_number": "321-831-6232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRAZI",
        "first_name": "MELISSA",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-04",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9561021",
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "FL",
            "license": "L311641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "ANCONA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.