MEDICARE: DR. AUDREY E MICHAL 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	2084P0800X	Psychiatry Physician	ME68340	FL

General Provider Information

NPI Number	:	1962559708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUDREY E MICHAL MD

Provider Business Mailing Address
First Line	:	914 BAY BLVD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32503-6806
Country	:	US
Telephone Number	:	850-438-8309
Fax Number	:	850-438-8309

Provider Business Practice Location Address
First Line	:	914 BAY BLVD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32503-6806
Country	:	US
Telephone Number	:	850-438-8309
Fax Number	:	850-438-8309

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

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	07/24/2007

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