Healthcare Provider Details

I. General information

NPI: 1104213537
Provider Name (Legal Business Name): MICHAELA GAFFLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2015
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 W UNDERWOOD ST
ORLANDO FL
32806-1110
US

IV. Provider business mailing address

110 W UNDERWOOD ST
ORLANDO FL
32806-1139
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-5111
  • Fax:
Mailing address:
  • Phone: 336-716-2011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME154365
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: