Provider Demographics
NPI:1114516358
Name:NARANJO, GELSY
Entity type:Individual
Prefix:
First Name:GELSY
Middle Name:
Last Name:NARANJO
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 1:695 E 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4611
Mailing Address - Country:US
Mailing Address - Phone:786-908-3527
Mailing Address - Fax:
Practice Address - Street 1:695 E 8TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4611
Practice Address - Country:US
Practice Address - Phone:786-908-3527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2099363A00000X
OK37770208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice