Provider Demographics
NPI:1851397749
Name:GELINAS, WILLIAM RICHARD (DO)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:RICHARD
Last Name:GELINAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11535 W EMERALD OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34428-2815
Mailing Address - Country:US
Mailing Address - Phone:352-794-6191
Mailing Address - Fax:352-794-6193
Practice Address - Street 1:11535 W EMERALD OAKS DR
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34428-2815
Practice Address - Country:US
Practice Address - Phone:352-794-6191
Practice Address - Fax:352-794-6193
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL058292208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL260728000Medicaid
FL260728000Medicaid
FL58035AMedicare ID - Type Unspecified