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General NPI Number Information
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NPI Number | 1649308669
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Entity Type | Individual
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Provider Name | MICHELLE ANNE KIRWAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 03/12/2014
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Provider Practice Location Address
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Address Line | 4100 S HOSPITAL DR STE 110
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City | PLANTATION
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State | FL
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Zip | 33317-2831
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Country | US
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Telephone | 954-584-8222
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Fax | 954-584-8224
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Provider Business Mailing Address
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Address Line | 19380 COLLINS AVE APT 1212
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City | SUNNY ISLES BEACH
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State | FL
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Zip | 33160-2237
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME88448
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License Number State | FL
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