MEDICARE: MRS. MICHELE MCCOY BOCHERT ATC

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	2255A2300X	Athletic Trainer	AL 1936	FL

General Provider Information

NPI Number	:	1659579365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELE MCCOY BOCHERT ATC

Provider Business Mailing Address
First Line	:	13020 N TELECOM PKWY
Second Line	:
City	:	TEMPLE TERRACE
State	:	FL
Zip	:	33637-0925
Country	:	US
Telephone Number	:	813-978-9700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2653 BRUCE B DOWNS BLVD STE 201
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-9206
Country	:	US
Telephone Number	:	813-910-3368
Fax Number	:

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

Provider Enumeration Date	:	07/03/2007
Last Update Date	:	07/21/2022

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