Provider Demographics
NPI:1740242007
Name:CARMICHAEL, PATRICK REED (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:REED
Last Name:CARMICHAEL
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 1:6900 NW 9TH BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4251
Mailing Address - Country:US
Mailing Address - Phone:352-333-6680
Mailing Address - Fax:352-331-4006
Practice Address - Street 1:6900 NW 9TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4251
Practice Address - Country:US
Practice Address - Phone:352-333-6680
Practice Address - Fax:352-331-4006
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 30207207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL037068100Medicaid
FLD54788Medicare UPIN
FL42137ZMedicare ID - Type UnspecifiedMEDICARE
FL037068100Medicaid