# MRS. MICHELLE PINTO WADE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1518969377
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | PA9113264 | FL | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | MA051342 | PA | — |
| 363A00000X | Physician Assistant | PA113264 | FL | Yes |

## Other

- **Enumeration date:** 08/11/2005
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 113755000 | — | FL |
| 01 | — | MA051342 | MEDICAL LICENSE | PA |