Provider Demographics
NPI:1467602003
Name:TURNER, MICHELLE RENAE (MPT)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:RENAE
Last Name:TURNER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 MALABAR RD NE
Mailing Address - Street 2:NE SUITE 1
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-3245
Mailing Address - Country:US
Mailing Address - Phone:321-409-5777
Mailing Address - Fax:321-409-5888
Practice Address - Street 1:1155 MALABAR RD NE
Practice Address - Street 2:NE SUITE 1
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-3245
Practice Address - Country:US
Practice Address - Phone:321-409-5777
Practice Address - Fax:321-409-5888
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist