Provider Demographics
NPI:1326895327
Name:GELOVICH, ALYSSA ANN
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:ANN
Last Name:GELOVICH
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 1:752 HYPERION DR
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-0106
Mailing Address - Country:US
Mailing Address - Phone:321-304-7790
Mailing Address - Fax:
Practice Address - Street 1:2864 WELLNESS AVE STE 100
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8335
Practice Address - Country:US
Practice Address - Phone:386-575-4027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist