MEDICARE: DR. MARK MICHNIK MD

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	207V00000X	Obstetrics & Gynecology Physician	236807	NY
2	207V00000X	Obstetrics & Gynecology Physician	ME117870	FL

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841397650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK MICHNIK MD

Provider Business Mailing Address
First Line	:	101 RIVERFRONT BLVD STE 710
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34205-8812
Country	:	US
Telephone Number	:	941-776-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 NE 167TH ST
Second Line	:
City	:	N MIAMI BEACH
State	:	FL
Zip	:	33162-3402
Country	:	US
Telephone Number	:	786-300-7330
Fax Number	:	772-264-8106

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	12/11/2024

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Directions to “ DR. MARK MICHNIK MD” Practice Location

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