Healthcare Provider Details

I. General information

NPI: 1124478250
Provider Name (Legal Business Name): MICHELE ROSSI CHAMPIGNY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELE MARIE ROSSI

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SE DETROIT AVE
STUART FL
34994-2113
US

IV. Provider business mailing address

300 SE DETROIT AVE
STUART FL
34994-2113
US

V. Phone/Fax

Practice location:
  • Phone: 772-617-4277
  • Fax:
Mailing address:
  • Phone: 772-617-4277
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number5151010597
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number5101022679
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberOS20574
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number5151010597
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: