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Individual

MICHAEL A. IMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AA-C

Contact information

Practice address
2201 45TH STREET, WEST PALM BEACH, FL 33407
(954) 838-2371
(954) 851-1758
Mailing address
1613 N HARRISON PARKWAY, #200, SUNRISE, FL 33323-2853
(954) 838-2371
(954) 851-1746

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
001965
GA
367H00000X
Anesthesiologist Assistant
Primary
AA85
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100000751B
GA
05
100000751K
GA
01
87
NCCAA CERTIFICATE #
GA
Enumeration date
10/03/2006
Last updated
11/04/2011
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