Healthcare Provider Details

I. General information

NPI: 1013506344
Provider Name (Legal Business Name): JOHANNIE CLAUDE-FRANCOIS MICHEL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 08/09/2022
Certification Date: 08/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 W CYPRESS CREEK RD STE C100
FT LAUDERDALE FL
33309-1741
US

IV. Provider business mailing address

931 NE 158TH ST
NORTH MIAMI BEACH FL
33162-5305
US

V. Phone/Fax

Practice location:
  • Phone: 954-974-3111
  • Fax: 954-974-6191
Mailing address:
  • Phone: 305-610-1353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9113782
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: