Basic Information
Provider Information
NPI: 1851851778
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SETTEDUCATO
FirstName: MICHAEL
MiddleName: LOUIS
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 100265
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326100265
CountryCode: US
TelephoneNumber: 3522650239
FaxNumber: 3522651107
Practice Location
Address1: 1600 SW ARCHER RD STE 4102
Address2:  
City: GAINESVILLE
State: FL
PostalCode: 326103003
CountryCode: US
TelephoneNumber: 3522650239
FaxNumber: 3522651107
Other Information
ProviderEnumerationDate: 03/25/2019
LastUpdateDate: 08/01/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X FLN Student, Health CareStudent in an Organized Health Care Education/Training Program 
207R00000XME154521FLY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


Home