Provider Demographics
NPI:1831255322
Name:HENKELMAN, MICHAEL D (PT, ATC)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:D
Last Name:HENKELMAN
Suffix:
Gender:M
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2628 ALCLOBE CIR
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-8967
Mailing Address - Country:US
Mailing Address - Phone:407-578-5252
Mailing Address - Fax:
Practice Address - Street 1:811 S ORLANDO AVE STE H
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-7102
Practice Address - Country:US
Practice Address - Phone:407-628-5500
Practice Address - Fax:407-628-5505
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 0009941225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist