Provider Demographics
NPI:1508348681
Name:KELLINGER, MICHELLE NOE-LANIKAI (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:NOE-LANIKAI
Last Name:KELLINGER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8941 LAKE DR APT D205
Mailing Address - Street 2:
Mailing Address - City:CAPE CANAVERAL
Mailing Address - State:FL
Mailing Address - Zip Code:32920-4296
Mailing Address - Country:US
Mailing Address - Phone:321-459-1647
Mailing Address - Fax:321-459-1201
Practice Address - Street 1:1587 N COURTENAY PKWY
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4454
Practice Address - Country:US
Practice Address - Phone:321-459-1647
Practice Address - Fax:321-459-1201
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7448295-17011835P2201X
FLPS68983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS68983OtherPHARMACIST
UT7448295-1701OtherPHARMACIST
UT7448295-8911OtherCONTROLLED SUBSTANCES LICENSE