Provider Demographics
NPI:1346468758
Name:CHARLES L GELFMAN MD PA
Entity Type:Organization
Organization Name:CHARLES L GELFMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDEENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:LARRY
Authorized Official - Last Name:GELFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-750-8383
Mailing Address - Street 1:801 MEADOWS RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2346
Mailing Address - Country:US
Mailing Address - Phone:561-750-8083
Mailing Address - Fax:561-750-0065
Practice Address - Street 1:801 MEADOWS RD
Practice Address - Street 2:SUITE 117
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2346
Practice Address - Country:US
Practice Address - Phone:561-750-8083
Practice Address - Fax:561-750-0065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46432174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty