Provider Demographics
NPI:1356439020
Name:CONNOR, MICHAEL ADAM (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ADAM
Last Name:CONNOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4060 PGA BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6570
Mailing Address - Country:US
Mailing Address - Phone:561-845-6500
Mailing Address - Fax:561-845-6300
Practice Address - Street 1:4060 PGA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410
Practice Address - Country:US
Practice Address - Phone:561-845-6500
Practice Address - Fax:561-845-6300
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME97125207WX0200X, 207W00000X
TXN0706207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXN0706OtherTX STATE LICENSE
FLME97125OtherFLORIDA BOARD OF MEDICINE
TXN0706OtherTX STATE LICENSE
FLAD9470826-507772OtherDEA
FLME97125OtherFLORIDA BOARD OF MEDICINE
FLFC2465741OtherDEA