Individual
MR. MICHAEL JOHN DALE
Active
Individual
MR. MICHAEL JOHN DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA 9105384
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008214900
—
FL
01
—
PA9105384
FL PHYSICIAN ASSISTANT LICENSE NUMBER
FL
01
—
Y0F6V
BCBS
FL
Enumeration date
05/05/2010
Last updated
12/07/2016
Update your record
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