Basic Information
| Provider Information | |||||||||
| NPI: | 1891786893 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GELOVICH | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | P. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | FLORIDA HOSPITAL CENTRA CARE | ||||||||
| Address2: | 901 N. LAKE DESTINY DR, SUITE 400 | ||||||||
| City: | MAITLAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4072002300 | ||||||||
| FaxNumber: | 4072001365 | ||||||||
| Practice Location | |||||||||
| Address1: | 6001 VINELAND RD | ||||||||
| Address2: | SUITE 108 | ||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328197829 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073516682 | ||||||||
| FaxNumber: | 4073458389 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ME83639 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.