Provider Demographics
NPI:1447244678
Name:GELVIN, CHRISTOPHER R (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:R
Last Name:GELVIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 S EAST AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2344
Mailing Address - Country:US
Mailing Address - Phone:941-366-4440
Mailing Address - Fax:833-638-0060
Practice Address - Street 1:1217 S EAST AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2344
Practice Address - Country:US
Practice Address - Phone:941-366-4440
Practice Address - Fax:941-366-2049
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL74012207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL46426OtherBCBS
FLP00142884OtherMEDICARE RR
FL043683580OtherTAX ID
FL256140900Medicaid
FL46426OtherBCBS
FLP00142884OtherMEDICARE RR