Organization
DR. GISELE MARDY PEDIATRIC CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GISELE VICTOR MARDY M.D. (PRESIDENT)
(305) 253-6654
Entity
Organization
Contact information
Practice address
9299 SW 152ND ST STE 207, PALMETTO BAY, FL 33157-1776
(305) 253-6654
(305) 235-3501
Mailing address
9299 SW 152ND ST STE 207, PALMETTO BAY, FL 33157-1776
(305) 253-6654
(305) 235-3501
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0070216
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250371900
—
FL
Enumeration date
04/02/2015
Last updated
04/02/2015
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