Individual
MICHAEL YACOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610
(325) 273-5484
Mailing address
311 N CLYDE MORRIS BLVD STE 100, DAYTONA BEACH, FL 32114-2756
(386) 226-2662
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301093311
MI
2086S0129X
Vascular Surgery Physician
26404
WV
2086S0129X
Vascular Surgery Physician
63402
MN
2086S0129X
Vascular Surgery Physician
Primary
ME136710
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100748600
—
FL
Enumeration date
11/19/2012
Last updated
12/20/2019
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