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NPI Code Detail

MEDICARE: DR. GISELLE A. RADICE OD

MEDICARE: DR. GISELLE A. RADICE OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPC 3679FL

General Provider Information

NPI Number : 1366542045
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GISELLE A. RADICE OD
Provider Business Mailing Address
First Line : 8614 WESTWOOD CENTER DR FL 9
Second Line :
City : VIENNA
State : VA
Zip : 22182-2442
Country : US
Telephone Number : 703-847-8899
Fax Number : 571-223-6780
Provider Business Practice Location Address
First Line : 333 PLAZA REAL
Second Line :
City : BOCA RATON
State : FL
Zip : 33432-3938
Country : US
Telephone Number : 561-392-8383
Fax Number : 561-392-1134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2006
Last Update Date : 04/16/2026

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