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Individual

DR. MICHAEL DOUGLAS MCCLEARY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
25 W CRYSTAL LAKE ST, SUITE 200, ORLANDO, FL 32806-4475
(407) 254-2522
(407) 254-2557
Mailing address
25 W CRYSTAL LAKE ST, SUITE 200, ORLANDO, FL 32806-4475
(407) 254-2522
(407) 254-2557

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME98424
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
35.085825
STATE MEDICAL LICENSE
OH
01
ME98424
STATE MEDICAL LICENSE
FL
Enumeration date
05/11/2007
Last updated
03/16/2010
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