Provider Demographics
NPI:1457874414
Name:DR. MICHAEL A. NOCERO JR. MD MACC PA
Entity Type:Organization
Organization Name:DR. MICHAEL A. NOCERO JR. MD MACC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOCERO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:407-760-1703
Mailing Address - Street 1:103 SATSUMA DR
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-6505
Mailing Address - Country:US
Mailing Address - Phone:407-760-1703
Mailing Address - Fax:
Practice Address - Street 1:616 E ALTAMONTE DR
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-4823
Practice Address - Country:US
Practice Address - Phone:407-262-0966
Practice Address - Fax:407-951-6364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-21
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty