Individual
MICHELLE ROUNTREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
10360 SW 186 ST #970150, MIAMI, FL 33197
(954) 222-2222
Mailing address
10360 SW 186 ST #970150, MIAMI, FL 33197
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 3831
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6208622 00
—
FL
01
—
AF740
MEDICARE PTAN
FL
Enumeration date
07/14/2006
Last updated
03/06/2015
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