Provider Demographics
NPI:1194029447
Name:SENKO, MICHELLE M
Entity type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:M
Last Name:SENKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2455 HOLLYWOOD BLVD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33020-6605
Mailing Address - Country:US
Mailing Address - Phone:954-453-1101
Mailing Address - Fax:954-453-1102
Practice Address - Street 1:2455 HOLLYWOOD BLVD
Practice Address - Street 2:SUITE 215
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33020-6605
Practice Address - Country:US
Practice Address - Phone:954-453-1101
Practice Address - Fax:954-453-1102
Is Sole Proprietor?:No
Enumeration Date:2010-12-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211378163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health