Provider Demographics
NPI:1245401330
Name:GENTILELLA, SHEILA M (LMT)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:M
Last Name:GENTILELLA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 FERN MEADOW LOOP
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4790
Mailing Address - Country:US
Mailing Address - Phone:407-342-1474
Mailing Address - Fax:
Practice Address - Street 1:471 FERN MEADOW LOOP
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4790
Practice Address - Country:US
Practice Address - Phone:407-342-1474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA-0016941225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist