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General NPI Number Information
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NPI Number | 1023021359
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Entity Type | Organization
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Legal Business Name | MICHAEL A WORMAN DDS PA
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5353 FIRST AVE SOUTH SUITE B
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City | ST PETERSBURG
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State | FL
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Zip | 33707-6516
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Country | US
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Telephone | 727-321-6911
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Fax | 727-328-2120
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Provider Business Mailing Address
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Address Line | 5353 FIRST AVE SOUTH SUITE B
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City | ST PETERSBURG
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State | FL
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Zip | 33707-6519
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Country | US
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Telephone | 727-321-6911
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Fax | 727-328-2120
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Authorized Official
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Title or Position | PRES
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Name | DR. MICHAEL A WORMAN
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Credential | DDS
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Telephone | 727-321-6911
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN5007
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License Number State | FL
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