Provider Demographics
NPI:1184435695
Name:CABEZAS-DELAPAZ, MICHELLE VI-CRISTAL
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:VI-CRISTAL
Last Name:CABEZAS-DELAPAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 MONROE CENTER ST NW STE 600
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2911
Mailing Address - Country:US
Mailing Address - Phone:616-200-7291
Mailing Address - Fax:
Practice Address - Street 1:77 MONROE CENTER ST NW STE 600
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2911
Practice Address - Country:US
Practice Address - Phone:616-200-7291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIN24108402246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy