Provider Demographics
NPI:1659009116
Name:MICHEL, ISABELLE BENDY
Entity Type:Individual
Prefix:MR
First Name:ISABELLE
Middle Name:BENDY
Last Name:MICHEL
Suffix:
Gender:F
Credentials:
Other - Prefix:MR
Other - First Name:ISA
Other - Middle Name:BENDY
Other - Last Name:MICHEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:21033 PINE KNOT LN
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34637-7827
Mailing Address - Country:US
Mailing Address - Phone:813-755-0890
Mailing Address - Fax:
Practice Address - Street 1:5447 E BEAUMONT CENTER BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-5210
Practice Address - Country:US
Practice Address - Phone:888-754-0398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician