Individual
MS. BERLIE PLACIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1095 NW SAINT LUCIE WEST BLVD, PORT ST LUCIE, FL 34986-1719
(772) 785-5570
(772) 785-5553
Mailing address
PO BOX 417, STUART, FL 34995-0417
(772) 223-5665
(772) 223-5646
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9103128
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002296200
—
FL
01
—
Y04SA
FLORIDA BLUE
FL
Enumeration date
02/01/2007
Last updated
10/09/2020
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