| Ms Gwendolyn Bruch Michaelman, PA | |
|
3001 W Dr Martin Luther King Jr Blvd, Tampa, FL 33607-6307 | |
| (813) 870-4000 | |
| Not Available |
| Full Name | Ms Gwendolyn Bruch Michaelman |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Medical |
| Location | 3001 W Dr Martin Luther King Jr Blvd, Tampa, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619094174 | NPI | - | NPPES |
| 292912100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | Q62542 (Connecticut) | Secondary |
| 363AM0700X | Physician Assistant - Medical | PA9104166 (Florida) | Primary |
| Entity Name | Brevard Physician Associates PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598008955 PECOS PAC ID: 1850535048 Enrollment ID: O20130909000619 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Gwendolyn Bruch Michaelman, PA 2727 W Dr Martin Luther King Jr Blvd, Suite Number 300, Tampa, FL 33607-6383 Ph: (813) 874-5707 | Ms Gwendolyn Bruch Michaelman, PA 3001 W Dr Martin Luther King Jr Blvd, Tampa, FL 33607-6307 Ph: (813) 870-4000 |
Sara Elizabeth Udani, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 10150 Highland Manor Dr Ste 205, Tampa, FL 33610 Phone: 813-259-1013 Fax: 813-254-0396 |
Randi Marie Bustin, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1502 E Fowler Ave, Tampa, FL 33612 Phone: 813-866-0950 Fax: 813-866-0929 |
Mrs. Jennifer Rose Baker Koebert, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4001 E Fletcher Ave Fl 6, Tampa, FL 33613 Phone: 813-396-0768 |
Frances Ivelisse Bernardo Mercado, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 12902 Usf Magnolia Dr, Tampa, FL 33612 Phone: 813-745-4673 |
Kyle Fernandez, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1 Tampa General Cir, Tampa, FL 33606 Phone: 813-844-7000 |
Maheen Rahim Jussab Ismail, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 12902 Usf Magnolia Dr, Tampa, FL 33612 Phone: 888-663-3488 |
Tracie L Patel, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 10740 Palm River Rd Ste 360, Tampa, FL 33619 Phone: 813-844-7585 Fax: 813-844-5877 |