Male or Other

Mr. Joshua A. Michaelman PA-C

Surgical Physician Assistant in Melbourne, FL(View on Map)

Full Name

Mr. Joshua Adam Seth Michaelman PA-C

NPI Number

1043327448

NPI Type

Individual Provider

Gender

Male

Enumeration Date

08/23/2006

Specialties

(Taxonomies)

Code

363AS0400X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

PA 9104113

Contact
Information

Purpose

Mailing
Location

Address

3300 S FISKE BLVD
1350 HICKORY ST

City

Rockledge
Melbourne

State

FL
FL

Postal Code

32955-4306
32901-3224

Country

US
US

Telephone Number

N/A
(321) 434-3455

Identifiers

Identifier

102086700
P01390678
AG195Q
PA9104113

Identifier State

FL
FL
FL
FL

Identifier Issuer

Unknown
FL RR MEDICARE
FL MEDICARE
LICENSE

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

Data last updated by provider on 03/10/2020

Provider Address

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