Provider Demographics
NPI:1760888283
Name:DANCY, MICHAEL (CSFA, CST)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:DANCY
Suffix:
Gender:M
Credentials:CSFA, CST
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Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1270 N WICKHAM RD STE 16-422
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-8923
Mailing Address - Country:US
Mailing Address - Phone:321-890-2022
Mailing Address - Fax:
Practice Address - Street 1:749 MCDERMOTT AVE
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-3038
Practice Address - Country:US
Practice Address - Phone:321-890-2022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical