Provider Demographics
NPI:1679351332
Name:DRISCOLL, MICHAEL PATRICK III (PA-C)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:PATRICK
Last Name:DRISCOLL
Suffix:III
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:9616 RIVER WALK CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-6534
Mailing Address - Country:US
Mailing Address - Phone:321-299-6821
Mailing Address - Fax:
Practice Address - Street 1:6535 NEMOURS PKWY
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7884
Practice Address - Country:US
Practice Address - Phone:407-567-4327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant