Provider Demographics
NPI:1508855339
Name:GELLMAN, JOEL (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:GELLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 SE 3RD AVE
Mailing Address - Street 2:THIRD FLOOR
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2564
Mailing Address - Country:US
Mailing Address - Phone:954-847-4273
Mailing Address - Fax:
Practice Address - Street 1:6333 N FEDERAL HWY
Practice Address - Street 2:SUITE 400
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-1913
Practice Address - Country:US
Practice Address - Phone:954-566-8367
Practice Address - Fax:954-566-6488
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME85643207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL265124600Medicaid
FL265124600Medicaid
FL29048ZMedicare PIN
F70869Medicare UPIN