Organization
MICHAEL J. WILEY, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JUNIOUS WILEY M.D. (OFFICER)
(813) 961-1677
Entity
Organization
Contact information
Practice address
3901 HENDERSON BLVD, TAMPA, FL 33629-5015
(813) 287-8439
Mailing address
3901 HENDERSON BLVD, TAMPA, FL 33629-5015
(813) 287-8439
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME0041556
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881779593
NPI
—
Enumeration date
01/11/2010
Last updated
06/21/2010
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