Individual
MICHAEL P TEEPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2222 S. HARBOR CITY BLVD, SUITE 420, MELBOURNE, FL 32901
(321) 768-9914
(321) 953-1893
Mailing address
2222 S. HARBOR CITY BLVD, SUITE 420, MELBOURNE, FL 32901
(321) 768-9914
(321) 953-1893
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA9102926
FL
363AM0700X
Medical Physician Assistant
PA9110026
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9110026
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120065100
—
FL
01
—
RW988
MEDICARE HF
FL
Enumeration date
01/19/2017
Last updated
10/30/2023
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