Provider Demographics
NPI:1235140260
Name:MURIEL, MICHELLE DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:DAVID
Last Name:MURIEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:M
Other - Last Name:LE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9154 WOODBRIDGE OAK TERRACE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825
Mailing Address - Country:US
Mailing Address - Phone:407-482-3860
Mailing Address - Fax:407-240-9508
Practice Address - Street 1:5308 S JOHN YOUNG PKWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-7362
Practice Address - Country:US
Practice Address - Phone:407-240-9766
Practice Address - Fax:407-240-9508
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME75715208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH78723Medicare UPIN