Individual
AMY KRISTEN MICKLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1106 DRUID RD S, DEPARTMENT OF RADIOLOGY, CLEARWATER, FL 33756-3846
(727) 441-3711
Mailing address
PO BOX 917368, ORLANDO, FL 32891-0001
(727) 793-9300
(727) 793-0661
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
135564
NC
2085R0202X
Diagnostic Radiology Physician
Primary
ME98736
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278336300
—
FL
01
—
90739
BCBSFL
FL
01
—
P00427228
RR MEDICARE
FL
Enumeration date
02/06/2007
Last updated
03/06/2012
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