MEDICARE: DR. MICHAEL NORMAN PIERCE M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	204864	NY
2	207R00000X	Internal Medicine Physician	ME81857	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	040AV1	OTHER	NY	MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	123280	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1205859188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL NORMAN PIERCE M.D

Provider Business Mailing Address
First Line	:	PO BOX 14303
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33302-4303
Country	:	US
Telephone Number	:	954-530-9591
Fax Number	:	954-530-9597

Provider Business Practice Location Address
First Line	:	4055 N ANDREWS AVE
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33309-5269
Country	:	US
Telephone Number	:	954-530-9591
Fax Number	:	954-530-9597

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	05/07/2019

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Directions to “ DR. MICHAEL NORMAN PIERCE M.D” Practice Location

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