NPI 1013242619

Michael John Provost, AA

Practitioner Anesthesiologist Assistant Gainesville, FL

Practice location

Address: 1600 SW Archer Rd, Gainesville, FL 32610-3003
Phone: (352) 265-0077
Fax: (352) 265-6922
Mailing address: PO Box 918025, Orlando, FL 32891-8025

Registered specialties

Anesthesiologist Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 367H00000X Licence AA41 (FL)

Other Anesthesiologist Assistant providers in Florida →

Registry record

NPI: 1013242619
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Oct 2009
Record last updated: 15 Feb 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.