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General NPI Number Information
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NPI Number | 1922175249
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Entity Type | Organization
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Legal Business Name | MICHELE E. WILLEY D.O. P.A.
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 22065 STATE ROAD 7
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City | BOCA RATON
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State | FL
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Zip | 33428-4219
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Country | US
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Telephone | 561-372-0999
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Fax |
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Provider Business Mailing Address
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Address Line | 22065 STATE ROAD 7
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City | BOCA RATON
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State | FL
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Zip | 33428-4219
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Country | US
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Telephone | 561-372-0999
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELE ELIZABETH WILLEY
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Credential | D.O.
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Telephone | 561-372-0999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS7138
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License Number State | FL
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