Individual
MICHELLE S PAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4288 WOODBINE RD, SUITE D, PACE, FL 32571-8795
(850) 995-8600
(850) 995-9060
Mailing address
4288 WOODBINE RD, SUITE D, PACE, FL 32571-8782
(850) 995-8600
(850) 995-9060
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME77356
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259249500
—
FL
01
—
35565
BLUE CROSS & BLUE SHIELD
FL
01
—
591-84273
BLUE CROSS & BLUE SHIELD
AL
Enumeration date
05/04/2006
Last updated
11/22/2011
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