Healthcare Provider Details

I. General information

NPI: 1366638249
Provider Name (Legal Business Name): DOREEN MICHEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2007
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4010 S 57TH AVE STE 101
GREENACRES FL
33463-4301
US

IV. Provider business mailing address

4010 S 57TH AVE STE 101
GREENACRES FL
33463-4301
US

V. Phone/Fax

Practice location:
  • Phone: 561-408-2169
  • Fax:
Mailing address:
  • Phone: 561-429-5950
  • Fax: 561-328-7620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number16880
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberACN1351
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301115801
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: