Provider Demographics
NPI:1609077064
Name:MENDELSOHN, MICHELLE S (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:S
Last Name:MENDELSOHN
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 STIRLING RD
Mailing Address - Street 2:# 3
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2041
Mailing Address - Country:US
Mailing Address - Phone:954-963-5000
Mailing Address - Fax:954-963-5077
Practice Address - Street 1:3230 STIRLING RD
Practice Address - Street 2:# 3
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-2041
Practice Address - Country:US
Practice Address - Phone:954-963-5000
Practice Address - Fax:954-963-5077
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT1003225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist