Provider Demographics
NPI:1215627955
Name:MCGEACHY, MICHELLE (DO)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:MCGEACHY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:WORONKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5207 NEFF LAKE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601-8018
Mailing Address - Country:US
Mailing Address - Phone:813-217-1940
Mailing Address - Fax:
Practice Address - Street 1:5207 NEFF LAKE RD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-8018
Practice Address - Country:US
Practice Address - Phone:813-217-1940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program