MEDICARE: DR. MICHELE MCGOWAN D.P.M.

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
1	213ES0103X	Foot & Ankle Surgery Podiatrist	PO2977	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	65755	OTHER	FL	BC/BS
2	043604213	OTHER	FL	TRICARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	043604213	OTHER	FL	CIGNA
5	4690780001	OTHER	FL	PALMETTO GBA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053330589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELE MCGOWAN D.P.M.

Provider Business Mailing Address
First Line	:	3190 CITRUS TOWER BLVD STE A
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-6886
Country	:	US
Telephone Number	:	352-242-2502
Fax Number	:	352-242-0316

Provider Business Practice Location Address
First Line	:	3190 CITRUS TOWER BLVD STE A
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-6886
Country	:	US
Telephone Number	:	352-242-2502
Fax Number	:	352-242-0316

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	12/19/2025

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Directions to “ DR. MICHELE MCGOWAN D.P.M.” Practice Location

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