Provider Demographics
NPI:1699268649
Name:MICHEL, JOHNNY (MD)
Entity type:Individual
Prefix:DR
First Name:JOHNNY
Middle Name:
Last Name:MICHEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2623 S SEACREST BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7535
Mailing Address - Country:US
Mailing Address - Phone:561-509-1200
Mailing Address - Fax:561-509-1064
Practice Address - Street 1:2623 S SEACREST BLVD STE 104
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7535
Practice Address - Country:US
Practice Address - Phone:561-509-1200
Practice Address - Fax:561-509-1064
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME149364207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program