Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 06296 | GA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 073972 | GA |
NPI | 1316387178 |
---|---|
Provider Name | Dr. Michelle Camille Forrester Covington |
First Address | Altamonte Springs, FL 32714-2415 |
Second Address | Altamonte Springs, FL 32714-2415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2013 |
Last Update Date | 05/10/2021 |