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General NPI Number Information
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NPI Number | 1538666250
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Entity Type | Individual
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Provider Name | MICKEY EMMANUEL MD
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Gender | Female
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 601 E ROLLINS ST
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City | ORLANDO
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State | FL
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Zip | 32803-1248
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Country | US
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Telephone | 407-599-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 IRVING ST NW APT 950
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City | WASHINGTON
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State | DC
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Zip | 20010-3531
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Country | US
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Telephone | 813-843-4793
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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 | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number | MD049261
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 207PP0204X
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Taxonomy Name | Pediatric Emergency Medicine (Emergency Medicine) Physician
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License Number | ME169582
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License Number State | FL
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