Individual provider Active NPI

Michael Daniel Lavelanet, PA-C

  • Public Health & General Preventive Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1144069543
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
9118607 Issued in FL
Practice address
3708 N Ocean Blvd
Fort Lauderdale, FL 33308-6451
Phone
(954) 909-4998
NPI assigned
May 23, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 9118607 FL Primary

Addresses

Primary practice location

3708 N Ocean Blvd
Fort Lauderdale, FL 33308-6451

Mailing address

5654 NW 101St Dr
Coral Springs, FL 33076-2592
Phone (954) 806-3714

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9118607FLMDPublic Health & General Preventive Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1144069543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5654 NW 101ST DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330762592",
            "telephone_number": "954-806-3714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 N OCEAN BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333086451",
            "telephone_number": "954-909-4998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVELANET",
        "first_name": "MICHAEL",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "FL",
            "license": "9118607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.