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NPI Code Detail

MEDICARE: MICHELLE KATHERINE FARINA

MEDICARE:   MICHELLE KATHERINE FARINA
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
1363A00000XPhysician Assistant
2363AM0700XMedical Physician Assistant9116568FL

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 : 1568103885
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE KATHERINE FARINA
Provider Business Mailing Address
First Line : 8433 SOUTHSIDE BLVD APT 1604
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-0712
Country : US
Telephone Number : 813-285-9843
Fax Number :
Provider Business Practice Location Address
First Line : 6675 CORPORATE CENTER PKWY STE 115
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-8088
Country : US
Telephone Number : 904-245-8910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/02/2022
Last Update Date : 09/29/2022

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Directions to “ MICHELLE KATHERINE FARINA ” Practice Location

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