MEDICARE: MICHELLE E MURILLO PA-C

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	363AS0400X	Surgical Physician Assistant	PA 9103956	FL

General Provider Information

NPI Number	:	1952581787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE E MURILLO PA-C

Provider Business Mailing Address
First Line	:	8020 YOLANDA AVE
Second Line	:
City	:	RESEDA
State	:	CA
Zip	:	91335-1257
Country	:	US
Telephone Number	:	760-567-1393
Fax Number	:

Provider Business Practice Location Address
First Line	:	8020 YOLANDA AVE
Second Line	:
City	:	RESEDA
State	:	CA
Zip	:	91335-1257
Country	:	US
Telephone Number	:	760-567-1393
Fax Number	:

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

Provider Enumeration Date	:	11/08/2007
Last Update Date	:	05/09/2016

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Directions to “ MICHELLE E MURILLO PA-C” Practice Location

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