Provider Demographics
NPI:1871816835
Name:DUHANEY, MICHELLE CAMILLE (DO)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:CAMILLE
Last Name:DUHANEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 N MILITARY TRL STE 210
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6308
Mailing Address - Country:US
Mailing Address - Phone:561-808-8502
Mailing Address - Fax:
Practice Address - Street 1:2900 N MILITARY TRL STE 210
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6308
Practice Address - Country:US
Practice Address - Phone:561-808-8502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10669207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine