Provider Demographics
NPI:1932187010
Name:MARCELIN, GISLAINE (MD)
Entity Type:Individual
Prefix:
First Name:GISLAINE
Middle Name:
Last Name:MARCELIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3717 W BOYNTON BEACH BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-4540
Mailing Address - Country:US
Mailing Address - Phone:561-734-1212
Mailing Address - Fax:561-734-1443
Practice Address - Street 1:3717 W BOYNTON BEACH BLVD STE 5
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-4540
Practice Address - Country:US
Practice Address - Phone:561-734-1212
Practice Address - Fax:561-734-1443
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69315207R00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice