Provider Demographics
NPI:1649605577
Name:SOUCY, BRIGITTE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:BRIGITTE
Middle Name:
Last Name:SOUCY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BRIGITTE
Other - Middle Name:
Other - Last Name:DEARMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:9400 SW 80TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-7409
Mailing Address - Country:US
Mailing Address - Phone:786-467-4661
Mailing Address - Fax:
Practice Address - Street 1:9555 SW 162ND AVE
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-6408
Practice Address - Country:US
Practice Address - Phone:786-467-4661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA9107377363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant