Provider Demographics
NPI:1518684513
Name:MICHEL, DIEUVEUT (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:DIEUVEUT
Middle Name:
Last Name:MICHEL
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2476 TIMBER FOREST DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-3625
Mailing Address - Country:US
Mailing Address - Phone:575-605-8353
Mailing Address - Fax:
Practice Address - Street 1:3003 S CONGRESS AVE STE 2E
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-2169
Practice Address - Country:US
Practice Address - Phone:561-305-1622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ049629363AM0700X
PRPA1242363AM0700X
FL9574670163W00000X
WI22662246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No163W00000XNursing Service ProvidersRegistered Nurse
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant