Individual
MS. GISELLE QUAN VIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1190 NW 95TH ST STE 200, MIAMI, FL 33150-2064
(305) 691-2550
(305) 696-4610
Mailing address
15280 NW 79TH CT STE 200, MIAMI LAKES, FL 33016-5873
(305) 558-3724
(786) 907-4485
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
363AM0700X
Medical Physician Assistant
PA9106643
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9106643
FLORIDA LICENSE NUMBER
FL
Enumeration date
10/01/2012
Last updated
12/19/2022
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