Healthcare Provider Details

I. General information

NPI: 1649268475
Provider Name (Legal Business Name): ROCHEL G GELINAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 03/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5355 LYONS RD
COCONUT CREEK FL
33073-2825
US

IV. Provider business mailing address

4855 W HILLSBORO BLVD STE B-2
COCONUT CREEK FL
33073-4356
US

V. Phone/Fax

Practice location:
  • Phone: 954-570-9595
  • Fax:
Mailing address:
  • Phone: 954-570-9595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME81349
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: