Provider Demographics
NPI:1639110125
Name:BINFORD, MICHAEL ASHTON (MD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ASHTON
Last Name:BINFORD
Suffix:
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 1:495 FLORA CREEK CT.
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746
Mailing Address - Country:US
Mailing Address - Phone:407-324-4560
Mailing Address - Fax:407-324-5565
Practice Address - Street 1:1401 W. SEMINOLE BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771
Practice Address - Country:US
Practice Address - Phone:407-321-4500
Practice Address - Fax:407-667-4338
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68242207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL68750OtherBCBS
FL377572100Medicaid
FL377572100Medicaid
FLE87611Medicare UPIN
FL68750ZMedicare PIN
68750WMedicare Oscar/Certification