MEDICARE: MICHELLE MCGEACHY DO

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1215627955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE MCGEACHY DO

Provider Business Mailing Address
First Line	:	1881 SE TIFFANY AVE STE 101
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-7567
Country	:	US
Telephone Number	:	772-335-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1881 SE TIFFANY AVE STE 101
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-7567
Country	:	US
Telephone Number	:	772-335-4000
Fax Number	:

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

Provider Enumeration Date	:	05/08/2023
Last Update Date	:	07/19/2025

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Directions to “ MICHELLE MCGEACHY DO” Practice Location

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