Provider Demographics
NPI:1881683654
Name:MICHEL, BERL A (DC)
Entity Type:Individual
Prefix:
First Name:BERL
Middle Name:A
Last Name:MICHEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9121 N MILITARY TRL
Mailing Address - Street 2:STE 208
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-5984
Mailing Address - Country:US
Mailing Address - Phone:561-627-2747
Mailing Address - Fax:561-691-2098
Practice Address - Street 1:9121 N MILITARY TRL
Practice Address - Street 2:STE 208
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-5984
Practice Address - Country:US
Practice Address - Phone:561-627-2747
Practice Address - Fax:561-691-2098
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-14
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005855111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22615Medicare PIN