Individual
MICHELLE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5825 HIGHWAY 90, MILTON, FL 32583-1763
(850) 266-3430
(850) 626-3431
Mailing address
5776 PEBBLE RIDGE DR, MILTON, FL 32583-2305
(619) 723-0731
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
5054
AZ
363AM0700X
Medical Physician Assistant
Primary
PA 9105934
FL
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
04/04/2006
Last updated
04/18/2019
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