Individual
JOHN L. MICHAELOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1030 W BAY DR, LARGO, FL 33770-3225
(727) 585-2200
(727) 584-9239
Mailing address
1030 W BAY DR, LARGO, FL 33770-3225
(727) 585-2200
(813) 697-1758
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME68672
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0797481
AETNA PROVIDER ID
FL
01
—
27298
BCBS FLORIDA PROVIDER ID
FL
05
—
379316800
—
FL
Enumeration date
04/03/2006
Last updated
11/13/2024
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