Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | M54084 | MD |
N | 111NI0900X | Internist | M54084 | MD |
N | 207RH0000X | Hematologist | M54084 | MD |
N | 207RX0202X | Medical Oncology | M54084 | MD |
Y | 207RX0202X | Medical Oncology | ME120661 | FL |
NPI | 1295747624 |
---|---|
Provider Name | Giselle Mery |
First Address | Orange City, FL 32763-8316 |
Second Address | Deland, FL 32720-3144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
012854500 | (05) | FL |
380170500 | (05) | MD |
D0059244 | MEDICAL LICENSE (01) | MD |
H68505 | (02) | MD |
ME120661 | FL LICENSE (01) | FL |