Individual
DR. GREGORY A MICHAELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
63 BARKLEY CIR, STE. 100 & 101, FORT MYERS, FL 33907-4514
(239) 938-3500
(239) 278-0055
Mailing address
13131 CORBEL CIR, #312, FORT MYERS, FL 33907-6833
(239) 267-2030
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
G61922
CA
2085R0202X
Diagnostic Radiology Physician
Primary
ME82942
FL
2085R0204X
Vascular & Interventional Radiology Physician
G61922
CA
2085R0204X
Vascular & Interventional Radiology Physician
ME 82942
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
226258
AMERIGROUP
—
05
—
264701000
—
FL
01
—
5773317
CIGNA
—
01
—
ME82942
FL WC CERTIFICATION
—
01
—
O6452
BCBSFL
—
01
—
P00318896
RR MEDICARE FRL
FL
Enumeration date
05/25/2006
Last updated
11/17/2010
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