Individual provider · Type 1 NPI

Gwendolyn Bruch Michaelman, P.A.

Medical Physician Assistant · Tampa, FL

NPI number 1619094174 Active

Practice location

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307

Call (813) 870-4000 Map

Mailing address

2727 W Dr Martin Luther King Jr Blvd, Suite Number 300
Tampa, FL 33607-6383

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700XQ62542 (CT)
Medical Physician Assistant Primary 363AM0700XPA9104166 (FL)

Medical Physician Assistant: Definition to come...

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About NPI 1619094174

Gwendolyn Bruch Michaelman, P.A.'s National Provider Identifier is 1619094174, issued on Mar 22, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Tampa, FL. The record was last updated on Jun 30, 2008.