Individual
MICHAEL FLETCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8202
(904) 396-5682
(904) 346-0864
Mailing address
820 PRUDENTIAL DR STE 713, JACKSONVILLE, FL 32207-8209
(904) 396-5682
(904) 346-0864
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME93209
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01160902
AMERIGROUP
GA
01
—
16086
BCBS
FL
05
—
2727625-00
—
FL
05
—
769747228A
—
GA
05
—
769747228C
—
GA
Enumeration date
07/17/2006
Last updated
06/11/2008
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