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General NPI Number Information
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NPI Number | 1023196169
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Entity Type | Individual
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Provider Name | MICHELE WORTHY DMD
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Gender | Female
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 11/01/2018
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Provider Practice Location Address
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Address Line | 7205 SE MARICAMP RD
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City | OCALA
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State | FL
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Zip | 34472-2105
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Country | US
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Telephone | 352-680-7001
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Fax |
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Provider Business Mailing Address
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Address Line | 18796 SW 27TH CT
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City | MIRAMAR
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State | FL
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Zip | 33029-2524
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Country | US
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Telephone | 954-616-9743
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN14803
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License Number State | FL
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