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General NPI Number Information
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NPI Number | 1710931662
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Entity Type | Individual
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Provider Name | MICHAEL CAMPANELLI DO
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Gender | Male
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 1325 LAKELAND HILLS BLVD LAKELAND REGIONAL NEUROSURGICAL ASSOCIATES
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City | LAKELAND
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State | FL
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Zip | 33805-4544
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Country | US
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Telephone | 863-603-6542
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Fax | 863-603-6529
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Provider Business Mailing Address
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Address Line | PO BOX 917770
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City | ORLANDO
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State | FL
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Zip | 32891-0001
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | OS8177
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | OS8177
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License Number State | FL
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