Individual
DR. MICHELLE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
699 W COCOA BEACH CSWY, STE 405, COCOA BEACH, FL 32931-3577
(321) 868-8330
(321) 868-8336
Mailing address
PO BOX 561600, ROCKLEDGE, FL 32956-1600
(321) 434-4600
(321) 434-4662
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
ME91540
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1056501
—
FL
05
—
271064100
—
FL
Enumeration date
07/22/2005
Last updated
06/22/2011
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