Basic Information
| Provider Information | |||||||||
| NPI: | 1578983847 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLETCHER | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1150 NW 14TH ST STE 502 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331362116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052434530 | ||||||||
| FaxNumber: | 3052434938 | ||||||||
| Practice Location | |||||||||
| Address1: | 1150 NW 14TH ST STE 502 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331362116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052434530 | ||||||||
| FaxNumber: | 3052434938 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2014 | ||||||||
| LastUpdateDate: | 07/02/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 25MA10283500 | NJ | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 390200000X | FL | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207V00000X | ME139845 | FL | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.