MEDICARE: GELEEN SALCEDO PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	22445	FL
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11026858	FL

General Provider Information

NPI Number	:	1013031459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GELEEN SALCEDO PMHNP-BC

Provider Business Mailing Address
First Line	:	7157 NARCOOSSEE RD UNIT 1001
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-5533
Country	:	US
Telephone Number	:	913-340-0164
Fax Number	:

Provider Business Practice Location Address
First Line	:	7157 NARCOOSSEE RD UNIT 1001
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-5533
Country	:	US
Telephone Number	:	913-340-0164
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	11/19/2024

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