Provider Demographics
NPI:1174953764
Name:JANVIER, VANESSA GELIANE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:GELIANE
Last Name:JANVIER
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:11373 SW 211TH ST
Mailing Address - Street 2:SUITE 16
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33189-2245
Mailing Address - Country:US
Mailing Address - Phone:305-234-0009
Mailing Address - Fax:305-234-8688
Practice Address - Street 1:11373 SW 211TH ST
Practice Address - Street 2:SUITE 16
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33189-2245
Practice Address - Country:US
Practice Address - Phone:305-234-0009
Practice Address - Fax:305-234-8688
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2015-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9107394363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014303500Medicaid