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Organization
KINGS BAY FAMILY CARE PA
Active
Organization
KINGS BAY FAMILY CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL B MUELLER D.O. (PRESIDENT)
(352) 795-2273
Entity
Organization
Contact information
Practice address
9030 W FORT ISLAND TRL, SUITE 1, CRYSTAL RIVER, FL 34429-2412
(352) 795-2273
(352) 795-2296
Mailing address
14690 SPRING HILL DR, SUITE 101, SPRING HILL, FL 34609-8102
(352) 795-2273
(352) 795-2296
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS7801
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46431
BCBS
FL
01
—
DS4782
RAILROAD MEDICARE
FL
Enumeration date
06/03/2006
Last updated
08/10/2012
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