Provider Demographics
NPI:1083118004
Name:KEILSON, JESSICA MILIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MILIAN
Last Name:KEILSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5313 GRANADA BLVD
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2031
Mailing Address - Country:US
Mailing Address - Phone:786-291-2511
Mailing Address - Fax:
Practice Address - Street 1:1364 CLIFTON ROAD NE, SUITE H100
Practice Address - Street 2:EMORY UNIVERSITY HOSPITAL OFFICE OF SURGICAL EDUCATION
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-727-0093
Practice Address - Fax:404-712-0561
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program