Provider Demographics
NPI:1194002576
Name:MEYER, MICHAEL (DPT)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:MEYER
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10305 SW 24TH ST
Mailing Address - Street 2:APT # 102
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7902
Mailing Address - Country:US
Mailing Address - Phone:786-556-4497
Mailing Address - Fax:
Practice Address - Street 1:10305 SW 24TH ST
Practice Address - Street 2:102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7902
Practice Address - Country:US
Practice Address - Phone:786-556-4497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-13
Last Update Date:2011-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1212489225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist