MEDICARE: MICHELLE WILSON AU.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	231H00000X	Audiologist	AY1928	FL

General Provider Information

NPI Number	:	1891689915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE WILSON AU.D.

Provider Business Mailing Address
First Line	:	3024 LESLIE DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-6541
Country	:	US
Telephone Number	:	678-438-8098
Fax Number	:

Provider Business Practice Location Address
First Line	:	3024 LESLIE DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32806-6541
Country	:	US
Telephone Number	:	678-438-8098
Fax Number	:

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

Provider Enumeration Date	:	06/04/2025
Last Update Date	:	06/04/2025

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