Healthcare Provider Details

I. General information

NPI: 1295757904
Provider Name (Legal Business Name): MICHAEL JOSEPH CREAMER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 03/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WEST GORE STEET SUITE 500
ORLANDO FL
32806-1041
US

IV. Provider business mailing address

100 WEST GORE STEET SUITE 500
ORLANDO FL
32806-1041
US

V. Phone/Fax

Practice location:
  • Phone: 407-649-8707
  • Fax: 407-649-8373
Mailing address:
  • Phone: 407-649-8707
  • Fax: 407-649-8373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number056307
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: