Provider Demographics
NPI:1487894911
Name:EGGENBERGER, MICHELLE (DIPL ACU)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:EGGENBERGER
Suffix:
Gender:F
Credentials:DIPL ACU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13501 SW 136TH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-8321
Mailing Address - Country:US
Mailing Address - Phone:305-546-4872
Mailing Address - Fax:
Practice Address - Street 1:13501 SW 136TH ST STE 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-8321
Practice Address - Country:US
Practice Address - Phone:305-255-0190
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2602171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist