Healthcare Provider Details

I. General information

NPI: 1467415943
Provider Name (Legal Business Name): ROSARIO GELY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8740 N KENDALL DR SUITE 212
MIAMI FL
33176-2212
US

IV. Provider business mailing address

8740 N KENDALL DR SUITE 212
MIAMI FL
33176-2212
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-5956
  • Fax: 305-595-5953
Mailing address:
  • Phone: 305-595-5956
  • Fax: 305-595-5953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME59198
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME059198
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: