Provider Demographics
NPI:1154389500
Name:WILKINSON, MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:WILKINSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12975 COLLIER BLVD STE 107
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-4004
Mailing Address - Country:US
Mailing Address - Phone:239-455-4181
Mailing Address - Fax:
Practice Address - Street 1:12975 COLLIER BLVD STE 107
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-4004
Practice Address - Country:US
Practice Address - Phone:239-455-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8640111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381970100Medicaid
FL70086AMedicare ID - Type Unspecified