Provider Demographics
NPI:1235397522
Name:OHARA, MICHAEL LOUIS SR (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LOUIS
Last Name:OHARA
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 WEST INDIANTOWN RD. STE. 206
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-7535
Mailing Address - Country:US
Mailing Address - Phone:561-748-4343
Mailing Address - Fax:561-748-9995
Practice Address - Street 1:658 W INDIANTOWN RD STE 206
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7535
Practice Address - Country:US
Practice Address - Phone:561-748-4343
Practice Address - Fax:561-748-9995
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12693102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst