Healthcare Provider Details

I. General information

NPI: 1508057100
Provider Name (Legal Business Name): MR. MICHAEL ALLEN POPIEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 08/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 GULF BEACH HWY SUITE E
PENSACOLA FL
32507-3289
US

IV. Provider business mailing address

1001 GULF BEACH HWY SUITE E
PENSACOLA FL
32507-3289
US

V. Phone/Fax

Practice location:
  • Phone: 850-456-4300
  • Fax: 850-456-4301
Mailing address:
  • Phone: 850-456-4300
  • Fax: 850-456-4301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA26732
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: