Provider Demographics
NPI:1134315096
Name:PEDRO L GELIGA MD PA
Entity Type:Organization
Organization Name:PEDRO L GELIGA MD PA
Other - Org Name:NEUROLOGICAL ASSOCIATES OF LAKE COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:L
Authorized Official - Last Name:GELIGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-787-7611
Mailing Address - Street 1:601 MEDICAL PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-7311
Mailing Address - Country:US
Mailing Address - Phone:352-787-7611
Mailing Address - Fax:352-787-7216
Practice Address - Street 1:601 MEDICAL PLAZA DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-7311
Practice Address - Country:US
Practice Address - Phone:352-787-7611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0053315174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053247900Medicaid
FL053247900Medicaid
FL40582Medicare PIN