Guevara, Jade Gieseke

Guevara, Jade Gieseke is an sole proprietor health care provider with primary practice located at 601 N Flamingo Rd Ste 215 , Pembroke Pines FL 33028-1015. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is her primary health care specialty. Guevara, Jade Gieseke can be contacted via phone (954) 452-9922.

Contact Information

Primary practice address
601 N Flamingo Rd Ste 215 Pembroke Pines FL 33028-1015
Phone: (954) 452-9922
Fax: (352) 265-1107
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X ME136354 Florida

Profile Details

NPI number 1780003459
LBN Legal business name Guevara, Jade Gieseke
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 10th, 2014
Last updated Apr 14th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780003459 NPPES
Florida MEDICAID 025124300

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