Provider Demographics
NPI:1902481609
Name:PIERRE, PATRICKS GLORYA
Entity Type:Individual
Prefix:
First Name:PATRICKS
Middle Name:GLORYA
Last Name:PIERRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 SW 34TH ST APT BB274
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-1482
Mailing Address - Country:US
Mailing Address - Phone:786-916-0594
Mailing Address - Fax:
Practice Address - Street 1:3800 SW 34TH ST APT BB274
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-1482
Practice Address - Country:US
Practice Address - Phone:786-916-0594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-14
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty