Provider Demographics
NPI:1396006664
Name:GELLADY ALALOF, JESSICA SUE (ARNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:SUE
Last Name:GELLADY ALALOF
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4738 GRAND BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-5170
Mailing Address - Country:US
Mailing Address - Phone:727-807-7800
Mailing Address - Fax:727-807-7878
Practice Address - Street 1:4738 GRAND BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-5170
Practice Address - Country:US
Practice Address - Phone:727-807-7800
Practice Address - Fax:727-807-7878
Is Sole Proprietor?:No
Enumeration Date:2012-06-04
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9224726363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner