Healthcare Provider Details

I. General information

NPI: 1104843176
Provider Name (Legal Business Name): ANTHONY A MIKULEC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 FLOYD ST
SARASOTA FL
34239-2932
US

IV. Provider business mailing address

PO BOX 947407
ATLANTA GA
30394-7407
US

V. Phone/Fax

Practice location:
  • Phone: 941-366-9222
  • Fax:
Mailing address:
  • Phone: 941-917-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number2004011779
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number2004011779
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License NumberME182249
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: