Individual
MICHELLE JANICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12880 COMMODITY PL, TAMPA, FL 33626-3101
(813) 343-5500
(813) 343-5506
Mailing address
1905 ROBINHILL CT, TUCKER, GA 30084-7020
(404) 403-2816
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9106533
FL
Other
Enumeration date
05/14/2012
Last updated
05/14/2012
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