| Dr. Carol L. Bloomquist Mikulka Md Pa | |
|
214 Tyree Ln Winter Park FL 32792-4135 | |
| (407) 645-3777 | |
| (407) 645-1123 |
| Full Name | Dr. Carol L. Bloomquist Mikulka Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 214 Tyree Ln, Winter Park, Florida |
| Authorized Official Name and Position | Carol Bloomquist Mikulka (MEDICAL DOCTOR) |
| Authorized Official Contact | 4076453777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Carol L. Bloomquist Mikulka Md Pa 214 Tyree Ln Winter Park FL 32792-4135 Ph: (407) 645-3777 | Dr. Carol L. Bloomquist Mikulka Md Pa 214 Tyree Ln Winter Park FL 32792-4135 Ph: (407) 645-3777 |
| NPI Number | 1396920500 |
|---|---|
| Provider Enumeration Date | 01/07/2008 |
| Last Update Date | 04/10/2023 |
| Certification Date | 06/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396920500 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | ME0050632 (Florida) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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