Provider Demographics
NPI:1447874029
Name:BENZ, MICHELE CHERIE (ATC, CSCS, GTS)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:CHERIE
Last Name:BENZ
Suffix:
Gender:F
Credentials:ATC, CSCS, GTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7460 SW 118TH ST
Mailing Address - Street 2:
Mailing Address - City:PINECREST
Mailing Address - State:FL
Mailing Address - Zip Code:33156-4572
Mailing Address - Country:US
Mailing Address - Phone:305-235-1360
Mailing Address - Fax:
Practice Address - Street 1:7460 SW 118TH ST
Practice Address - Street 2:
Practice Address - City:PINECREST
Practice Address - State:FL
Practice Address - Zip Code:33156-4572
Practice Address - Country:US
Practice Address - Phone:305-235-1360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-30
Last Update Date:2020-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL11962255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer