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Organization
MICHAEL T REILLY MD PA
Active
Organization
MICHAEL T REILLY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL T REILLY MD (PRESIDENT)
(727) 821-1132
Entity
Organization
Contact information
Practice address
1201 5TH AVE N, SUITE 401, ST PETERSBURG, FL 33705-1400
(727) 821-1132
(727) 822-2977
Mailing address
1201 5TH AVE N, SUITE 401, ST PETERSBURG, FL 33705-1400
(727) 821-1132
(727) 822-2977
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME32973
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045627600
—
FL
Enumeration date
10/23/2012
Last updated
11/20/2012
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