Individual
MICHAEL TICHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
12511 WORLD PLAZA LN BLDG 50, FORT MYERS, FL 33907-3991
(239) 939-2622
(239) 939-0151
Mailing address
14621 SHERBROOK PL, #205, FORT MYERS, FL 33912-7079
(239) 939-2622
(239) 939-0151
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9241276
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G4036
BLUE CROSS
FL
01
—
P00367248
RAILROAD MEDICARE
FL
Enumeration date
05/20/2006
Last updated
02/28/2013
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