Provider Demographics
NPI:1689887028
Name:GELLINEAU, PATRICIA COLEEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:COLEEN
Last Name:GELLINEAU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15780 SW 139TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-6848
Mailing Address - Country:US
Mailing Address - Phone:302-235-9091
Mailing Address - Fax:305-969-0919
Practice Address - Street 1:15780 SW 139TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-6848
Practice Address - Country:US
Practice Address - Phone:302-235-9091
Practice Address - Fax:305-969-0919
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS23655183500000X
FLPU36391835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835G0303XPharmacy Service ProvidersPharmacistGeriatric