Provider Demographics
NPI:1831903996
Name:OSNE GILLES, MYRIELLE PERPHENIE
Entity type:Individual
Prefix:
First Name:MYRIELLE
Middle Name:PERPHENIE
Last Name:OSNE GILLES
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 1:7900 W MCNAB RD
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-4303
Mailing Address - Country:US
Mailing Address - Phone:954-726-9020
Mailing Address - Fax:954-597-7222
Practice Address - Street 1:7900 W MCNAB RD
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-4303
Practice Address - Country:US
Practice Address - Phone:954-726-9020
Practice Address - Fax:954-597-7222
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO8025156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician