Demenkow, Michelle Rene

Demenkow, Michelle Rene is an sole proprietor health care provider with primary practice located at 14201 W Sunrise Blvd Suite 208, Sunrise FL 33323-3207. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Demenkow, Michelle Rene can be contacted via phone (954) 851-9690.

Contact Information

Primary practice address
14201 W Sunrise Blvd Suite 208 Sunrise FL 33323-3207
Phone: (954) 851-9690
Fax: (954) 851-9688
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PY6763 Florida
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X ARNP9211884 Florida

Profile Details

NPI number 1063606614
LBN Legal business name Demenkow, Michelle Rene
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 28th, 2007
Last updated Apr 16th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063606614 NPPES
Florida MEDICAID 17568900

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