Provider Demographics
NPI:1891758165
Name:ENGELMAN, MICHAEL WAYNE (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:WAYNE
Last Name:ENGELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 UNIVERSITY DR
Mailing Address - Street 2:STE K
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065
Mailing Address - Country:US
Mailing Address - Phone:954-752-2630
Mailing Address - Fax:954-752-9391
Practice Address - Street 1:3000 UNIVERSITY DR
Practice Address - Street 2:STE K
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:954-752-2630
Practice Address - Fax:954-752-9391
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME37097207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL511782OtherUNITED
FL93838OtherBC/BS FLORIDA
FL209877OtherAVMED
FL04085048OtherAETNA
FL070003806OtherMEDICARE RAILROAD
FL5794286OtherGHI
FL93838ZMedicare ID - Type Unspecified
FL5794286OtherGHI