Individual
DR. MICHAEL WARREN FOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1210 WATERMAN WAY, TAVARES, FL 32778-5229
(352) 343-2364
(352) 253-0022
Mailing address
1210 WATERMAN WAY, TAVARES, FL 32778-5229
(352) 343-2364
(352) 253-0022
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
OS10783
FL
Other
Enumeration date
10/19/2008
Last updated
09/09/2015
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