Provider Demographics
NPI:1902009509
Name:GHELFI, RENE' TERESA
Entity Type:Individual
Prefix:MS
First Name:RENE'
Middle Name:TERESA
Last Name:GHELFI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4855 MANDARIN BLVD
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-3555
Mailing Address - Country:US
Mailing Address - Phone:561-792-1898
Mailing Address - Fax:
Practice Address - Street 1:4855 MANDARIN BLVD
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-3555
Practice Address - Country:US
Practice Address - Phone:561-792-1898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA49370225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist