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NPI Code Detail

MEDICARE: DR. MICHELE WORTHY DMD

MEDICARE: DR. MICHELE WORTHY DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDN14803FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023196169
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHELE WORTHY DMD
Provider Business Mailing Address
First Line : 18796 SW 27TH CT
Second Line :
City : MIRAMAR
State : FL
Zip : 33029-2524
Country : US
Telephone Number : 954-616-9743
Fax Number :
Provider Business Practice Location Address
First Line : 7205 SE MARICAMP RD
Second Line :
City : OCALA
State : FL
Zip : 34472-2105
Country : US
Telephone Number : 352-680-7001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 11/01/2018

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