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Individual
MRS. MICHELLE PINTO WADE
Active
Individual
MRS. MICHELLE PINTO WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
PA9113264
FL
2080A0000X
Pediatric Adolescent Medicine Physician
MA051342
PA
363A00000X
Physician Assistant
Primary
PA113264
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113755000
—
FL
01
—
MA051342
MEDICAL LICENSE
PA
Enumeration date
08/11/2005
Last updated
03/07/2023
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