Individual
MR. CHARLES MICELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
465 SUMMERHAVEN DR, SUITE 1-A, DEBARY, FL 32713-5211
(407) 493-8181
(407) 788-3075
Mailing address
1405 HEARTHSTONE LN, LONGWOOD, FL 32750-3343
(407) 493-8181
(407) 788-3075
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW5546
FL
Other
Enumeration date
06/17/2013
Last updated
06/17/2013
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