Provider Demographics
NPI:1629449178
Name:MICHAEL W HIGGINS DO PA DBA HERNANDO ORTHOPAEDIC & SPINAL SURGERY
Entity Type:Organization
Organization Name:MICHAEL W HIGGINS DO PA DBA HERNANDO ORTHOPAEDIC & SPINAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:352-688-6035
Mailing Address - Street 1:13020 FORT KING RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33525-5222
Mailing Address - Country:US
Mailing Address - Phone:352-688-6035
Mailing Address - Fax:352-688-6219
Practice Address - Street 1:13020 FORT KING RD
Practice Address - Street 2:SUITE 102
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525-5222
Practice Address - Country:US
Practice Address - Phone:352-688-6035
Practice Address - Fax:352-688-6219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-09
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7550207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271767100Medicaid
FL271767100Medicaid