Provider Demographics
NPI:1104102714
Name:GELINAS, SHELLY H (PHARMD)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:H
Last Name:GELINAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9833 BAYWINDS DR APT 7203
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1854
Mailing Address - Country:US
Mailing Address - Phone:561-254-6365
Mailing Address - Fax:
Practice Address - Street 1:15940 ORANGE BLVD
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-3442
Practice Address - Country:US
Practice Address - Phone:561-899-1379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS42563183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist