Provider Demographics
NPI:1285692962
Name:GELIA, CHARLES B (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:B
Last Name:GELIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:15320 AMBERLY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1647
Mailing Address - Country:US
Mailing Address - Phone:813-977-0733
Mailing Address - Fax:813-971-2230
Practice Address - Street 1:7 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2523
Practice Address - Country:US
Practice Address - Phone:716-505-5630
Practice Address - Fax:716-892-1936
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0086215207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E97028Medicare UPIN
62702ZMedicare ID - Type Unspecified