Provider Demographics
NPI:1417123290
Name:PULICE, GAYLE GERARDI (LMT)
Entity Type:Individual
Prefix:MRS
First Name:GAYLE
Middle Name:GERARDI
Last Name:PULICE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:927 N A1A
Mailing Address - Street 2:SIUTE A105
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477
Mailing Address - Country:US
Mailing Address - Phone:561-747-8794
Mailing Address - Fax:561-747-8794
Practice Address - Street 1:927 NORTH A1A
Practice Address - Street 2:SUITE A105
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477
Practice Address - Country:US
Practice Address - Phone:561-747-8794
Practice Address - Fax:561-747-8794
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA00814225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist