Individual
MICHELE ANNE MCCARTHY-LAVISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1223 GATEWAY DR, MELBOURNE, FL 32901-2607
(321) 549-0752
(321) 952-2330
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 549-0752
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN1599172
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307549400
—
FL
01
—
E0558V
FL MEDICARE
FL
01
—
P01789933
FL RR MEDICARE
FL
Enumeration date
09/12/2005
Last updated
05/09/2024
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