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General NPI Number Information
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NPI Number | 1578622213
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Entity Type | Individual
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Provider Name | MICHELLE LEE ESTEVEZ MD
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Gender | Female
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 08/10/2014
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Provider Practice Location Address
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Address Line | 13330 USF LAUREL DR
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City | TAMPA
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State | FL
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Zip | 33612-6601
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Country | US
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Telephone | 813-974-2201
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Fax | 813-974-7550
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Provider Business Mailing Address
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Address Line | 2904 W BAY VILLA AVE
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City | TAMPA
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State | FL
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Zip | 33611-1606
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Country | US
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Telephone |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A95002
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME110636
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | ME110636
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License Number State | FL
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