MEDICARE: MR. MICHAEL CURTISS M.D.

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	207Q00000X	Family Medicine Physician	ME93358	FL

General Provider Information

NPI Number	:	1942460902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL CURTISS M.D.

Provider Business Mailing Address
First Line	:	2039 E EDGEWOOD DR
Second Line	:	SUITE B
City	:	LAKELAND
State	:	FL
Zip	:	33803-3601
Country	:	US
Telephone Number	:	863-577-1092
Fax Number	:	863-577-1099

Provider Business Practice Location Address
First Line	:	2039 E EDGEWOOD DR
Second Line	:	SUITE B
City	:	LAKELAND
State	:	FL
Zip	:	33803-3601
Country	:	US
Telephone Number	:	863-577-1092
Fax Number	:	863-577-1099

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

Provider Enumeration Date	:	06/12/2008
Last Update Date	:	08/15/2008

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