Organization
MICHELLE P GILLESPIE DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELLE GILLESPIE DO (PRESIDENT)
(954) 232-6754
Entity
Organization
Contact information
Practice address
2330 W HORATIO ST STE 200, TAMPA, FL 33609-3590
(813) 284-0954
Mailing address
2812 W ALLINE AVE, TAMPA, FL 33611-2806
(954) 232-6754
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00655170
—
FL
Enumeration date
07/23/2020
Last updated
07/23/2020
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