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Individual

DR. MICHELLE LUNDEEN PENNIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
900 PINE ST, STE 122-123, ENGLEWOOD, FL 34223-4418
(941) 474-8811
(941) 473-0058
Mailing address
900 PINE ST, STE 123, ENGLEWOOD, FL 34223-4418
(941) 474-8811
(941) 473-0058

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
002099
GA
207N00000X
Dermatology Physician
2010011561
MO
207N00000X
Dermatology Physician
Primary
ME108521
FL

Other

Enumeration date
01/29/2008
Last updated
12/22/2012
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