Provider Demographics
NPI:1487036620
Name:CERAMI, MICHELLE JOSEPHINE (LM, CPM)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:JOSEPHINE
Last Name:CERAMI
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 NE 25TH TER
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7554
Mailing Address - Country:US
Mailing Address - Phone:561-501-0985
Mailing Address - Fax:561-908-6669
Practice Address - Street 1:2263 NW 2ND AVE STE 206
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7470
Practice Address - Country:US
Practice Address - Phone:561-501-0985
Practice Address - Fax:561-908-6669
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-24
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMW314176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL022120900Medicaid