Michael Arthur Borelli, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME0038682 Issued in FL

Practice address

2801 Kennedy St
Putnam County Health Department
Palatka, FL 32177-4109

Phone

(386) 326-3200

Fax

(386) 326-3350

NPI assigned

Sep 28, 2006

Last updated

Dec 11, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355184000000",
    "number": "1023100393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 332",
            "city": "CEDAR KEY",
            "state": "FL",
            "postal_code": "32625",
            "telephone_number": "352-543-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 KENNEDY ST",
            "address_2": "PUTNAM COUNTY HEALTH DEPARTMENT",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321774109",
            "telephone_number": "386-326-3200",
            "fax_number": "386-326-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORELLI",
        "first_name": "MICHAEL",
        "middle_name": "ARTHUR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME0038682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069472000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Palatka, FL
• Providers in Palatka, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.