Healthcare Provider Details

I. General information

NPI: 1750686564
Provider Name (Legal Business Name): CHRISTOPHER S. MCMICHAEL P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2011
Last Update Date: 07/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 4TH STREET NORTH ALL FLORIDA ORTHOPAEDIC ASSOCIATES, PA
ST. PETERSBURG FL
33703-3802
US

IV. Provider business mailing address

4600 4TH STREET NORTH ALL FLORIDA ORTHOPAEDIC ASSOCIATES, PA
ST. PETERSBURG FL
33703-3802
US

V. Phone/Fax

Practice location:
  • Phone: 727-527-5272
  • Fax: 727-522-7412
Mailing address:
  • Phone: 727-527-5272
  • Fax: 727-522-7412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9105882
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: