Healthcare Provider Details

I. General information

NPI: 1881493161
Provider Name (Legal Business Name): CONSTANTINA GELEP PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER ROAD, PO BOX 100296
GAINESVILLE FL
32610
US

IV. Provider business mailing address

1600 SW ARCHER ROAD, PO BOX 100296
GAINESVILLE FL
32610
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-8920
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY12680
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY12680
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: