Healthcare Provider Details

I. General information

NPI: 1952823767
Provider Name (Legal Business Name): FLOYD FERDINAND UY GELACIO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7345 WOODLAND DR STE C
INDIANAPOLIS IN
46278
US

IV. Provider business mailing address

7345 WOODLAND DR STE C
INDIANAPOLIS IN
46278-1737
US

V. Phone/Fax

Practice location:
  • Phone: 317-286-2885
  • Fax: 317-536-3097
Mailing address:
  • Phone: 317-286-2885
  • Fax: 317-536-3097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number62236
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4469
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number293758
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: