Healthcare Provider Details

I. General information

NPI: 1104102714
Provider Name (Legal Business Name): SHELLY H GELINAS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2011
Last Update Date: 10/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15940 ORANGE BLVD
LOXAHATCHEE FL
33470-3442
US

IV. Provider business mailing address

9833 BAYWINDS DR APT 7203
WEST PALM BEACH FL
33411-1854
US

V. Phone/Fax

Practice location:
  • Phone: 561-899-1379
  • Fax:
Mailing address:
  • Phone: 561-254-6365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS42563
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: