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General NPI Number Information
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NPI Number | 1467566992
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Entity Type | Individual
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Provider Name | DONNA CHERYL GELLMAN-RODRIGUEZ PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 07/15/2007
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Provider Practice Location Address
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Address Line | 4240 LAKELAND HIGHLANDS RD
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City | LAKELAND
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State | FL
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Zip | 33813-3113
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Country | US
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Telephone | 863-398-5813
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Fax | 863-683-6164
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Provider Business Mailing Address
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Address Line | 1140 COUNTRY OAKS LN
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City | LAKELAND
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State | FL
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Zip | 33810-8117
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Country | US
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Telephone | 863-398-5813
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Fax | 863-683-6164
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY5562
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License Number State | FL
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