Healthcare Provider Details
I. General information
NPI: 1073014049
Provider Name (Legal Business Name): MICHELLE'S THERAPIES CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/26/2018
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2070 MEADOWLANE AVE
MELBOURNE FL
32904-4950
US
IV. Provider business mailing address
14001 SW 105TH ST
MIAMI FL
33186-3124
US
V. Phone/Fax
- Phone: 321-467-4848
- Fax: 321-985-0329
- Phone: 305-308-6226
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AP3191 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | MA57712 |
| License Number State | FL |
VIII. Authorized Official
Name:
MICHELLE
ZAMORA
Title or Position: PRESIDENT
Credential: LAC. LMT
Phone: 305-308-6226