Provider Demographics
NPI:1487830139
Name:BELANGER, MICHELLE LYNN (AP)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:LYNN
Last Name:BELANGER
Suffix:
Gender:F
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 N PARK RD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-6917
Mailing Address - Country:US
Mailing Address - Phone:954-243-9954
Mailing Address - Fax:954-983-1160
Practice Address - Street 1:450 N PARK RD
Practice Address - Street 2:SUITE 401
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-6917
Practice Address - Country:US
Practice Address - Phone:954-243-9954
Practice Address - Fax:954-983-1160
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1862171100000X
MEAC252171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist