Healthcare Provider Details

I. General information

NPI: 1831742691
Provider Name (Legal Business Name): MICHAEL ALLAN THOMPSON DNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2019
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD UNIT 10-2
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

4441 NW 23RD DR
GAINESVILLE FL
32605-1778
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-6102
  • Fax:
Mailing address:
  • Phone: 954-861-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberAPRN11003005
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License NumberNP95037686
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: