Individual provider · Type 1 NPI

Keith-Allen Licyayo Melong, MD

Student in an Organized Health Care Education/Training Program · Jacksonville, FL

NPI number 1295537454 Active

Practice location

653-1 W 8th St
Jacksonville, FL 32209-6511

Call (904) 244-0441 Map

Mailing address

1301 Catherine St
Ann Arbor, MI 48109-2026

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1295537454

Keith-Allen Licyayo Melong, MD's National Provider Identifier is 1295537454, issued on Mar 26, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Jacksonville, FL. The record was last updated on Mar 26, 2025.