Healthcare Provider Details

I. General information

NPI: 1366789109
Provider Name (Legal Business Name): LINDA GELLATLY A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2013
Last Update Date: 07/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 N MISSOURI AVE
LAKELAND FL
33805-4411
US

IV. Provider business mailing address

47 5TH ST NW
WINTER HAVEN FL
33881-4672
US

V. Phone/Fax

Practice location:
  • Phone: 863-413-8600
  • Fax: 863-413-8650
Mailing address:
  • Phone: 863-229-7970
  • Fax: 863-837-4469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9228550
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: