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Individual

JENISE JEAN-GILLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
2564 W 72ND PL, HIALEAH, FL 33016-6507
(786) 334-3125
Mailing address
171 NE 209TH ST, MIAMI, FL 33179-1723
(754) 707-2066

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PTA30136
FL

Other

Enumeration date
11/18/2020
Last updated
11/18/2020
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