| Doctor Name: | MRS. MICHELLE HELENE CORMIER-BOECKLE |
| NPI Number: | 1053514224 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | ARNP1968192 |
| Business Practice Address: | 301 N Alexander St Plant City, FL - 335634303 |
| Business Phone Number: | 8137578343 |
| Business Fax Number: | |
| Mailing Address: | 11623 Meridian Point Drive, TAMPA |
| State: | FL |
| Postal Code: | 33626 |
| Phone Number: | 8137920309 |
| Fax Number: | |
| NPI Enumeration Date: | 06/06/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LN0000X |
| License Number: | ARNP1968192 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Neonatal |
| Taxonomy Definition: | |