Provider Demographics
NPI:1194266767
Name:SIERRA, MICHELLE (PT, DPT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:SIERRA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9140 SW 123RD CT
Mailing Address - Street 2:Q404
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-1974
Mailing Address - Country:US
Mailing Address - Phone:305-804-7887
Mailing Address - Fax:
Practice Address - Street 1:9140 SW 123RD CT
Practice Address - Street 2:Q404
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1974
Practice Address - Country:US
Practice Address - Phone:305-804-7887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-16
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist