Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Michelle Park

Individual provider Pediatrics Physician · NPI 1073254207

Michelle Park is a Pediatric Medicine in Jacksonville, Florida. Graduated from Alabama College of Osteopathic Medicine in 2022, 4 years ago. Licensed in Florida.

Years since qualifying
4
Trained at
Alabama College of Osteopathic Medicine
Licensed in
FL
In the registry since
2022
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Practice location Address checks out

6015 118th St
Jacksonville, FL 32244-3703
Phone: (904) 633-0610
Fax: (904) 633-0611
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence OS22077 (FL)

Record details

NPI number1073254207
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 3, 2022
Last updated in NPPESJuly 6, 2026
Certification dateJuly 6, 2026
Mailing addressPo Box 4408, Jacksonville, FL 32231-4008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolALABAMA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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