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1174084990
MICHAEL HIGGINBOTHAM
BRANDON, FL
NPI
1174084990
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2019-03-26
Last Update Date
2019-03-26
Business Address
MICHAEL HIGGINBOTHAM MD
119 OAKFIELD DR
BRANDON, FL 33511-5779
Phone number: 813-681-5551
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Mailing Address
MICHAEL HIGGINBOTHAM MD
123 STONEBRIDGE WAY
SENOIA, GA 30276-3365
Phone number:
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