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Female

Ms. Gwendolyn B. Michaelman P.A.

Medical Physician Assistant in Tampa, FL(View on Map)

Full Name

Ms. Gwendolyn Bruch Michaelman P.A.

NPI Number

1619094174

NPI Type

Individual Provider

Gender

Female

Enumeration Date

03/22/2007

Specialties

(Taxonomies)

Name

Medical Physician Assistant

Code

363AM0700X

Primary Taxonomy

Yes

Licenses

State

Connecticut
Florida

License Number

Q62542
PA9104166

Contact
Information

Purpose

Mailing
Location

Address

2727 W DR MARTIN LUTHER KING JR BLVD
3001 W DR MARTIN LUTHER KING JR BLVD

City

Tampa
Tampa

State

FL
FL

Postal Code

33607-6383
33607-6307

Country

US
US

Telephone Number

(813) 874-5707
(813) 870-4000

Identifiers

Identifier

292912100

Identifier State

FL

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/30/2008

Provider Address

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