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Michael
Michael
Small
Gastroenterology
Medical doctor
Lutz,
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Florida Board of Medicine
Board Name
BOARD OF MEDICINE
Full name
Michael Small
Job Title
Medical Doctor
License Number
ME104627
License Status
Clear/Active
License Issue Date
27/05/2009
License Expiry Date
31/01/2025
Source Type
Professional Profile
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Florida Health Care Practitioner Data Portal
Full name
MICHAEL SMALL
Job Title
Medical Doctor
Location
Lutz, FL, USA
LIC ID
103387
Current License Expiration Date
31/01/2025
Original Date
27/05/2009
Professional Rank Code
ME
Effective Date
09/01/2015
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
HILLSBOROUGH
Mailing Address Line 2
Suite 200
Practice Location Address Line 1
4211 VANDYKE RD
Practice Location Address Line 2
#200
Practice Location Address City
LUTZ
Practice Location Address State
FL
Practice Location Address Zipcode
33558-8004
Prescribing Indicator
N
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