Gough, Michelle K.

Gough, Michelle K. is an individual health care provider with primary practice located at 19615 State Road 7 Ste 32 , Boca Raton FL 33498-4700. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Gough, Michelle K. can be contacted via phone (561) 477-7700.

Contact Information

Primary practice address
19615 State Road 7 Ste 32 Boca Raton FL 33498-4700
Phone: (561) 477-7700
Fax: (561) 477-7707
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA9105990 Florida
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X T-01568 Kansas
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 15-01184 Kansas

Profile Details

NPI number 1730375601
LBN Legal business name Gough, Michelle K.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 24th, 2007
Last updated Aug 19th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730375601 NPPES
Florida MEDICAID 006452800
Florida MEDICAID 200535850B
Florida Other 016576006

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