Individual
MICHELLE ANN KEANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9611 W BROWARD BLVD, PLANTATION, FL 33324-2334
(954) 424-7000
(954) 436-0449
Mailing address
900 S PINE ISLAND RD STE 800, PLANTATION, FL 33324-3923
(954) 431-8000
(954) 436-0449
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME108902
FL
2080P0006X
Developmental - Behavioral Pediatrics Physician
ME108902
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004160700
—
FL
Enumeration date
08/17/2007
Last updated
02/15/2024
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