Provider Demographics
NPI:1326220526
Name:WITTELS, MICHAEL B (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:B
Last Name:WITTELS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 KANE CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLANDS
Mailing Address - State:FL
Mailing Address - Zip Code:33154-2105
Mailing Address - Country:US
Mailing Address - Phone:305-866-4664
Mailing Address - Fax:305-861-5558
Practice Address - Street 1:1085 KANE CONCOURSE
Practice Address - Street 2:
Practice Address - City:BAY HARBOR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154-2105
Practice Address - Country:US
Practice Address - Phone:305-866-4664
Practice Address - Fax:305-861-5558
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME41392207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL02823OtherBLUE CROSS BLUE SHIELD
0498480001Medicare NSC
FL02823OtherBLUE CROSS BLUE SHIELD