Provider Demographics
NPI:1902533565
Name:MICKEL, FLORINA (APRN)
Entity Type:Individual
Prefix:
First Name:FLORINA
Middle Name:
Last Name:MICKEL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 100214
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0214
Mailing Address - Country:US
Mailing Address - Phone:352-273-9400
Mailing Address - Fax:352-627-4268
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-4483
Practice Address - Country:US
Practice Address - Phone:352-273-9400
Practice Address - Fax:352-627-4268
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL9315879163WP2201X
FL11020657363L00000X
FLAPRN11020657363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116347100Medicaid