Provider Demographics
NPI:1538134903
Name:HIGGINS, MICHAEL W (D O P A)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:W
Last Name:HIGGINS
Suffix:
Gender:M
Credentials:D O P A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4055 MARINER BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-2467
Mailing Address - Country:US
Mailing Address - Phone:352-688-6035
Mailing Address - Fax:352-688-6219
Practice Address - Street 1:4055 MARINER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-2467
Practice Address - Country:US
Practice Address - Phone:352-688-6035
Practice Address - Fax:352-688-6219
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7550207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271767100Medicaid
FL271767100Medicaid