Provider Demographics
NPI:1851551154
Name:KENNETH M GELMAN MD PA
Entity Type:Organization
Organization Name:KENNETH M GELMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-432-2228
Mailing Address - Street 1:9900 STIRLING RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-8065
Mailing Address - Country:US
Mailing Address - Phone:954-432-2228
Mailing Address - Fax:954-432-7277
Practice Address - Street 1:9900 STIRLING RD
Practice Address - Street 2:SUITE 300
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-8065
Practice Address - Country:US
Practice Address - Phone:954-432-2228
Practice Address - Fax:954-432-7277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME49901174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty