Provider Demographics
NPI:1215135934
Name:MURPHY, MICHAEL C (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:MURPHY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4111 SW 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-2716
Mailing Address - Country:US
Mailing Address - Phone:352-870-9415
Mailing Address - Fax:
Practice Address - Street 1:1505 NW 16TH AVE
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4036
Practice Address - Country:US
Practice Address - Phone:352-870-9415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0003594103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL75814OtherBLUE CROSS AND BLUE SHIEL