Provider Demographics
NPI:1043412851
Name:GIQUEL, JADELIS (MD)
Entity Type:Individual
Prefix:
First Name:JADELIS
Middle Name:
Last Name:GIQUEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:YADELIS
Other - Middle Name:
Other - Last Name:PEREZ-QUEVEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12446 SW 9 TERRA
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33184
Mailing Address - Country:US
Mailing Address - Phone:305-227-8593
Mailing Address - Fax:
Practice Address - Street 1:JACKSON MEMORIAL HOSPITAL
Practice Address - Street 2:1611 NW 12 TH AVE
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-585-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN 8084390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program