MEDICARE: DR. JOHN MICHAEL KIEL DO

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	207P00000X	Emergency Medicine Physician	04183	KY
2	207QS0010X	Sports Medicine (Family Medicine) Physician	TP002	KY
3	207PS0010X	Sports Medicine (Emergency Medicine) Physician	OS15506	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	T3Q4W	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619387099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN MICHAEL KIEL DO

Provider Business Mailing Address
First Line	:	DEPARTMENT OF EMERGENCY MEDICINE
Second Line	:	655 WEST 8TH STREET, C506
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-3504
Country	:	US
Telephone Number	:	904-244-6340
Fax Number	:

Provider Business Practice Location Address
First Line	:	DEPARTMENT OF EMERGENCY MEDICINE, 125 FLOOR CLINICAL CE
Second Line	:	655 WEST 8TH STREET, C506
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-3220
Country	:	US
Telephone Number	:	904-244-6340
Fax Number	:

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

Provider Enumeration Date	:	05/06/2014
Last Update Date	:	01/18/2024

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Directions to “ DR. JOHN MICHAEL KIEL DO” Practice Location

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