Individual
GERALD MICELI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 CLYDE MORRIS BLVD STE A, ORMOND BEACH, FL 32174-5909
(386) 317-8620
(386) 317-8625
Mailing address
300 CLYDE MORRIS BLVD STE A, ORMOND BEACH, FL 32174-5909
(386) 317-8620
(386) 317-8625
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME62517
FL
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
ME62517
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25294
BCBS
FL
01
—
25294W
MEDICARE ID
FL
01
—
460003874
RAILROAD MEDICARE
FL
01
—
ME62517
VHN
FL
Enumeration date
03/23/2006
Last updated
05/17/2023
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