Provider Demographics
NPI:1962578591
Name:MICHEL, ALEJANDRO IGNACIO (MD)
Entity type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:IGNACIO
Last Name:MICHEL
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 1:14495 UNIVERSITY COVE PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3741
Mailing Address - Country:US
Mailing Address - Phone:813-336-8770
Mailing Address - Fax:813-866-0001
Practice Address - Street 1:14495 UNIVESITY COVE PLACE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3741
Practice Address - Country:US
Practice Address - Phone:813-336-8770
Practice Address - Fax:813-866-0001
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91564207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03416OtherFL BLUE
FL5417654OtherAETNA
FL297239OtherAUMED
FL592998397COtherHUMANA
FL03416OtherFL BLUE
FL5417654OtherAETNA
G31423Medicare UPIN