Healthcare Provider Details

I. General information

NPI: 1295488138
Provider Name (Legal Business Name): SHERLYNE J GELIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2022
Last Update Date: 02/01/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1604 SE 3RD AVE
GAINESVILLE FL
32641-7346
US

IV. Provider business mailing address

1105 FORT CLARKE BLVD APT 507
GAINESVILLE FL
32606-7127
US

V. Phone/Fax

Practice location:
  • Phone: 352-548-1800
  • Fax:
Mailing address:
  • Phone: 618-581-1683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.393877
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: