Healthcare Provider Details

I. General information

NPI: 1598783987
Provider Name (Legal Business Name): MICHAEL J ROONEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 10/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E LAKE HOWARD DR
WINTER HAVEN FL
33881-3155
US

IV. Provider business mailing address

160 E LAKE HOWARD DR
WINTER HAVEN FL
33881-3155
US

V. Phone/Fax

Practice location:
  • Phone: 863-299-1251
  • Fax: 863-299-7666
Mailing address:
  • Phone: 863-299-1251
  • Fax: 863-299-7666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License NumberME37717
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME37717
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberME37717
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: