Healthcare Provider Details

I. General information

NPI: 1477224582
Provider Name (Legal Business Name): VIOLETTE E MARKUSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VIOLETTE E TANGUAY PA-C

II. Dates (important events)

Enumeration Date: 09/28/2021
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SE HOSPITAL AVE
STUART FL
34994-2346
US

IV. Provider business mailing address

482 SE ESSEX DR
PORT ST LUCIE FL
34984-5156
US

V. Phone/Fax

Practice location:
  • Phone: 401-808-1156
  • Fax:
Mailing address:
  • Phone: 401-808-1156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number1477224582
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: