Healthcare Provider Details

I. General information

NPI: 1205531100
Provider Name (Legal Business Name): GISELLE ROSEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E OLYMPIA AVE UNIT 111
PUNTA GORDA FL
33950-3823
US

IV. Provider business mailing address

2675 WINKLER AVE STE 200
FORT MYERS FL
33901-9328
US

V. Phone/Fax

Practice location:
  • Phone: 941-639-1640
  • Fax:
Mailing address:
  • Phone: 863-280-6082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME178135
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: