# MICHELLE HENNE, M.D., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225564073
- **Authorized official:** MICHELLE HENNE M.D. (PRESIDENT)
- **Authorized official phone:** (321) 759-2562

## Contact information

- **Practice address:** 5421 S FLORIDA AVE, LAKELAND, FL 33813-2523
- **Practice address phone:** (863) 401-4401
- **Practice address fax:** (866) 824-2717
- **Mailing address:** 5421 S FLORIDA AVE, LAKELAND, FL 33813-2523
- **Mailing address phone:** (863) 401-4401
- **Mailing address fax:** (866) 824-2717

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | Yes |
| 261QS1000X | Student Health Clinic/Center | ME121120 | FL | — |

## Other

- **Enumeration date:** 05/11/2017
- **Last updated:** 08/17/2026