Provider Demographics
NPI:1558539171
Name:FELICETTA, GERALYNN ANN (AP, PT)
Entity Type:Individual
Prefix:
First Name:GERALYNN
Middle Name:ANN
Last Name:FELICETTA
Suffix:
Gender:F
Credentials:AP, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 TAMIAMI TRL N
Mailing Address - Street 2:SUITE 112
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5248
Mailing Address - Country:US
Mailing Address - Phone:239-404-6306
Mailing Address - Fax:239-404-6306
Practice Address - Street 1:1250 TAMIAMI TRL N
Practice Address - Street 2:SUITE 112
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5248
Practice Address - Country:US
Practice Address - Phone:239-404-6306
Practice Address - Fax:239-404-6306
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-17
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2233171100000X
FLPT51465174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No174400000XOther Service ProvidersSpecialist