=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750352068
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHELLE C POWELL DO MPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2006
-----------------------------------------------------
Last Update Date | 06/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16400 NW 2ND AVE STE 102
-----------------------------------------------------
City | NORTH MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33169-6035
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-948-4701
-----------------------------------------------------
Fax | 786-329-7223
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16400 NW 2ND AVE STE 102
-----------------------------------------------------
City | NORTH MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33169-6035
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-948-4701
-----------------------------------------------------
Fax | 786-329-7223
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | OS7263
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | XLOS0007263
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------