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NPI Code Detail

MEDICARE: MICHAEL J. WILEY, M.D., P.A.

MEDICARE: MICHAEL J. WILEY, M.D., P.A.
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
1208600000XSurgery PhysicianME0041556FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11881779593OTHERNPI

General Provider Information

NPI Number : 1427388644
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHAEL J. WILEY, M.D., P.A.
Provider Business Mailing Address
First Line : 3901 HENDERSON BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33629-5015
Country : US
Telephone Number : 813-287-8439
Fax Number :
Provider Business Practice Location Address
First Line : 3901 HENDERSON BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33629-5015
Country : US
Telephone Number : 813-287-8439
Fax Number :
Authorized Official
Title or Position : OFFICER
Name : DR. MICHAEL JUNIOUS WILEY
Credential : M.D.
Telephone Number : 813-961-1677
Provider Enumeration Date : 01/11/2010
Last Update Date : 06/21/2010

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