Provider Demographics
NPI:1013154111
Name:KELESIDIS, IOSIF (MD, MSC)
Entity Type:Individual
Prefix:DR
First Name:IOSIF
Middle Name:
Last Name:KELESIDIS
Suffix:
Gender:M
Credentials:MD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2477 BRUCE B DOWNS BLVD
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544
Mailing Address - Country:US
Mailing Address - Phone:813-788-1400
Mailing Address - Fax:
Practice Address - Street 1:2477 BRUCE B DOWNS BLVD
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544
Practice Address - Country:US
Practice Address - Phone:813-788-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA135517207RC0001X, 207RC0001X
PAMT204818207RC0000X
NY003602281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No281P00000XHospitalsChronic Disease Hospital