Provider Demographics
NPI:1043200181
Name:SINCLAIR, MICHAEL J (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:SINCLAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:13005 STATE ROAD 80
Mailing Address - Street 2:STE 111
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-9206
Mailing Address - Country:US
Mailing Address - Phone:561-798-2002
Mailing Address - Fax:561-798-3450
Practice Address - Street 1:13005 STATE ROAD 80
Practice Address - Street 2:STE 111
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9206
Practice Address - Country:US
Practice Address - Phone:561-798-2002
Practice Address - Fax:561-798-3450
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2015-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0047669207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD58311Medicare UPIN
FL73288Medicare ID - Type Unspecified