Healthcare Provider Details

I. General information

NPI: 1184671141
Provider Name (Legal Business Name): BRUCE A GELINAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 9TH STREET N STE 300
NAPLES FL
34102
US

IV. Provider business mailing address

399 9TH STREET N STE 300
NAPLES FL
34102
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-4200
  • Fax: 239-624-4201
Mailing address:
  • Phone: 239-624-4200
  • Fax: 239-624-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME91179
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: