Provider Demographics
NPI:1598269003
Name:TACL, MICHELE M (ARNP)
Entity Type:Individual
Prefix:MISS
First Name:MICHELE
Middle Name:M
Last Name:TACL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6041 SW 73RD STREET RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-6464
Mailing Address - Country:US
Mailing Address - Phone:352-629-1199
Mailing Address - Fax:352-629-1341
Practice Address - Street 1:6041 SW 73RD STREET RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-6464
Practice Address - Country:US
Practice Address - Phone:352-629-1199
Practice Address - Fax:352-629-1341
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9273227363LA2200X
FLARNP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health