Healthcare Provider Details

I. General information

NPI: 1134733157
Provider Name (Legal Business Name): DR. CHRISTINE MARIE MICHEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4722 SW COLLEGE RD
OCALA FL
34474-5741
US

IV. Provider business mailing address

601 S HARBOUR ISLAND BLVD STE 200
TAMPA FL
33602-5925
US

V. Phone/Fax

Practice location:
  • Phone: 352-351-0464
  • Fax:
Mailing address:
  • Phone: 727-322-3439
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number161404
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11025299
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: