Provider Demographics
NPI:1477618312
Name:WHITE, MICHAEL CORWIN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CORWIN
Last Name:WHITE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6910 MAIN ST APT 150
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-7013
Mailing Address - Country:US
Mailing Address - Phone:561-352-7893
Mailing Address - Fax:
Practice Address - Street 1:14645 NW 77TH AVE STE 107
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2569
Practice Address - Country:US
Practice Address - Phone:305-570-1965
Practice Address - Fax:305-570-1968
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 9043111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor