Individual
MEGAN ANN GIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2165 LITTLE RD, TRINITY, FL 34655-4410
(727) 372-6607
Mailing address
2165 LITTLE RD, TRINITY, FL 34655-4410
(727) 372-6607
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
9113362
FL
363AM0700X
Medical Physician Assistant
Primary
9113362
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117271200
—
FL
01
—
UT6FH
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/22/2019
Last updated
10/11/2023
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