Healthcare Provider Details

I. General information

NPI: 1255866315
Provider Name (Legal Business Name): MICHELLE L KRYKEWYCZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2017
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8004 NW 154TH ST STE 270
MIAMI LAKES FL
33016-5814
US

IV. Provider business mailing address

8004 NW 154TH ST STE 270
MIAMI LAKES FL
33016-5814
US

V. Phone/Fax

Practice location:
  • Phone: 786-521-1625
  • Fax:
Mailing address:
  • Phone: 786-521-1625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW20967
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: