Provider Demographics
NPI:1336651827
Name:LINDENAU, MICHELLE M (LMT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:LINDENAU
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5041 NE 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33334-5753
Mailing Address - Country:US
Mailing Address - Phone:561-843-6489
Mailing Address - Fax:
Practice Address - Street 1:4861 N DIXIE HWY STE 204
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3953
Practice Address - Country:US
Practice Address - Phone:754-229-9235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-25
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA81029225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist