Individual
MARLA D MICHAELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
137 HOSPITAL DR NE, FORT WALTON BEACH, FL 32548-5063
(850) 833-7500
(850) 833-7528
Mailing address
4447 TURNBERRY PL, NICEVILLE, FL 32578-3824
(850) 630-6707
(850) 833-7439
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME112006
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004621500
—
FL
01
—
049317
LICENSE
GA
Enumeration date
12/14/2006
Last updated
12/30/2014
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