Provider Demographics
NPI:1033535596
Name:MCPHERSON, MICHAEL LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEE
Last Name:MCPHERSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11705 BOYETTE RD
Mailing Address - Street 2:# 154
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-5533
Mailing Address - Country:US
Mailing Address - Phone:727-475-2608
Mailing Address - Fax:888-788-8345
Practice Address - Street 1:11705 BOYETTE RD
Practice Address - Street 2:# 154
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-5533
Practice Address - Country:US
Practice Address - Phone:888-788-8345
Practice Address - Fax:888-788-8345
Is Sole Proprietor?:No
Enumeration Date:2014-03-07
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11147111N00000X, 111NN1001X, 111NR0400X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician