=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881635951
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL PAUL BRUCE D.O
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2006
-----------------------------------------------------
Last Update Date | 03/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 351 NE 8TH AVE
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34470-5349
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-401-0060
-----------------------------------------------------
Fax | 352-401-3525
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 351 NE 8TH AVE
-----------------------------------------------------
City | OCALA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34470-5349
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-401-0060
-----------------------------------------------------
Fax | 352-401-3525
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH8782
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------