Healthcare Provider Details

I. General information

NPI: 1417036831
Provider Name (Legal Business Name): MICHELE LEE FLUKE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELE LEE SEWAR NP-C

II. Dates (important events)

Enumeration Date: 11/05/2006
Last Update Date: 11/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11180 SPRING HILL DR
SPRING HILL FL
34609-4648
US

IV. Provider business mailing address

9635 SHAMOKIN LN
PORT RICHEY FL
34668-3954
US

V. Phone/Fax

Practice location:
  • Phone: 727-841-7643
  • Fax:
Mailing address:
  • Phone: 727-841-7643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9191208
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: