Provider Demographics
NPI:1467415943
Name:GELY, ROSARIO (MD)
Entity Type:Individual
Prefix:
First Name:ROSARIO
Middle Name:
Last Name:GELY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8740 N KENDALL DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2212
Mailing Address - Country:US
Mailing Address - Phone:305-595-5956
Mailing Address - Fax:305-595-5953
Practice Address - Street 1:8740 N KENDALL DR
Practice Address - Street 2:SUITE 212
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2212
Practice Address - Country:US
Practice Address - Phone:305-595-5956
Practice Address - Fax:305-595-5953
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2021-12-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME59198208000000X
FLME059198208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1467415943Medicaid
FL263399000Medicaid