Healthcare Provider Details

I. General information

NPI: 1588428619
Provider Name (Legal Business Name): ADEL GELLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2024
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 NE 174TH ST
NORTH MIAMI BEACH FL
33162-2135
US

IV. Provider business mailing address

870 NE 174TH ST
NORTH MIAMI BEACH FL
33162-2135
US

V. Phone/Fax

Practice location:
  • Phone: 954-295-3955
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number17078
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: