Healthcare Provider Details

I. General information

NPI: 1689887028
Provider Name (Legal Business Name): PATRICIA COLEEN GELLINEAU PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15780 SW 139TH AVE
MIAMI FL
33177-6848
US

IV. Provider business mailing address

15780 SW 139TH AVE
MIAMI FL
33177-6848
US

V. Phone/Fax

Practice location:
  • Phone: 302-235-9091
  • Fax: 305-969-0919
Mailing address:
  • Phone: 302-235-9091
  • Fax: 305-969-0919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS23655
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberPU3639
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: