Healthcare Provider Details

I. General information

NPI: 1982752671
Provider Name (Legal Business Name): MICHAEL JAMES MUEHLBERGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 W MICHIGAN ST
ORLANDO FL
32806-4453
US

IV. Provider business mailing address

80 W MICHIGAN ST
ORLANDO FL
32806-4453
US

V. Phone/Fax

Practice location:
  • Phone: 407-648-4323
  • Fax: 407-839-1493
Mailing address:
  • Phone: 407-648-4323
  • Fax: 407-839-1493

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number89450
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME110487
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: