Provider Demographics
NPI:1013257088
Name:GEORGE MICHEL MD, PA.
Entity Type:Organization
Organization Name:GEORGE MICHEL MD, PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-200-7320
Mailing Address - Street 1:6140 SW 70TH ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-3419
Mailing Address - Country:US
Mailing Address - Phone:305-284-7577
Mailing Address - Fax:305-675-3714
Practice Address - Street 1:10620 SW 83RD AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156-3514
Practice Address - Country:US
Practice Address - Phone:786-543-1930
Practice Address - Fax:305-675-3714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67268207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty