Provider Demographics
NPI:1902094865
Name:MICHAEL MARKOU DO PLC
Entity type:Organization
Organization Name:MICHAEL MARKOU DO PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKOU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-446-0176
Mailing Address - Street 1:1266 TURNER ST
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-5921
Mailing Address - Country:US
Mailing Address - Phone:727-446-0176
Mailing Address - Fax:727-442-0696
Practice Address - Street 1:1266 TURNER ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-5921
Practice Address - Country:US
Practice Address - Phone:727-446-0176
Practice Address - Fax:727-442-0696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS6358207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40821OtherMEDICARE GROUP