Provider Demographics
NPI:1851457907
Name:MELANIPHY, MICHELLE (DOM)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:MELANIPHY
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:INGELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:1340 SE 3RD TER
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-6735
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1340 SE 3RD TER
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-6735
Practice Address - Country:US
Practice Address - Phone:203-400-9957
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-30
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2876171100000X
CT000169171100000X
FL3173171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist