Provider Demographics
NPI:1508057100
Name:POPIEL, MICHAEL ALLEN
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ALLEN
Last Name:POPIEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 GULF BEACH HWY
Mailing Address - Street 2:SUITE E
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-3289
Mailing Address - Country:US
Mailing Address - Phone:850-456-4300
Mailing Address - Fax:850-456-4301
Practice Address - Street 1:1001 GULF BEACH HWY
Practice Address - Street 2:SUITE E
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-3289
Practice Address - Country:US
Practice Address - Phone:850-456-4300
Practice Address - Fax:850-456-4301
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA26732225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC4012OtherBLUECROSSBLUESHIED OF FL