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Provider Information for 1770534240

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. MICHAEL T REILLY M.D.

Gender: MALE

Individual NPI: 1770534240

Calendar   Last Updated:  2015-03-24
  Certification Date: 

Details

Name Value
NPI 1770534240
Enumeration Date 2006-05-12
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1201 5TH AVE N SUITE 401
ST PETERSBURG, FL 33705
United States

Phone: 727-821-1132 | Fax: 727-822-2977
View Map External Link
Primary Practice Address 1201 5TH AVE NORTH SUITE 401
ST PETERSBURG, FL 33705
United States

Phone: 727-821-1132 | Fax: 727-822-2977
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207QA0505X - Family Medicine Adult Medicine FL ME32973