Individual
MR. JOSHUA ADAM SETH MICHAELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1350 HICKORY ST, SUITE 102, MELBOURNE, FL 32901-3224
(321) 434-3455
(321) 434-3456
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 9104113
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102086700
—
FL
01
—
AG195Q
FL MEDICARE
FL
01
—
P01390678
FL RR MEDICARE
FL
01
—
PA9104113
LICENSE
FL
Enumeration date
08/23/2006
Last updated
03/10/2020
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