Provider Demographics
NPI:1366638249
Name:MICHEL, DOREEN (MD)
Entity Type:Individual
Prefix:DR
First Name:DOREEN
Middle Name:
Last Name:MICHEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 S 57TH AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-4301
Mailing Address - Country:US
Mailing Address - Phone:561-429-5950
Mailing Address - Fax:561-328-7620
Practice Address - Street 1:4010 S 57TH AVE STE 101
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-4301
Practice Address - Country:US
Practice Address - Phone:561-408-2169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1351208D00000X
PR16880208D00000X
MI4301115801208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice