Michael John Provost, AA
NPI #1013242619 in Gainesville, Florida
Provider Information
- NPI Number
- 1013242619
- Entity Type
- Individual
- Name
- Michael John Provost, AA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Anesthesiologist Assistant
- Credential
- AA
- Enumeration Date
- Oct 15, 2009
- Last Updated
- Feb 15, 2010
Practice Location
- Address
- 1600 SW ARCHER RD
- City
- Gainesville
- State
- Florida
- ZIP Code
- 32610-3003
- Phone
- (352) 265-0077
Specialties & Taxonomy Codes
| Specialty |
|---|
| Anesthesiologist Assistant |
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