Provider Demographics
NPI:1427058601
Name:MYERS, MICHAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:MYERS
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 1:5534 GULF DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4000
Mailing Address - Country:US
Mailing Address - Phone:727-847-3992
Mailing Address - Fax:727-848-1118
Practice Address - Street 1:5534 GULF DR
Practice Address - Street 2:SUITE 1
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4000
Practice Address - Country:US
Practice Address - Phone:727-847-3992
Practice Address - Fax:727-848-1118
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0030364207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL406073190OtherRAILROAD MEDICARE
FL51087OtherBLUE CROSS BLUE SHIELD
FL04928OtherWELLCARE
FL2017767OtherAETNA
FL241992OtherAVMED
FL591798817OtherHUMANA
FL8550571-002OtherCIGNA
FL058995100Medicaid
FL591798817OtherQUALITY HEALTH PLANS
FL591798817OtherHUMANA
FL591798817OtherHUMANA
FL51087ZMedicare PIN