Provider Demographics
NPI:1891786893
Name:GELOVICH, STEPHEN P (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:P
Last Name:GELOVICH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:FLORIDA HOSPITAL CENTRA CARE
Mailing Address - Street 2:901 N. LAKE DESTINY DR, SUITE 400
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751
Mailing Address - Country:US
Mailing Address - Phone:407-200-2300
Mailing Address - Fax:407-200-1365
Practice Address - Street 1:6001 VINELAND RD
Practice Address - Street 2:SUITE 108
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7829
Practice Address - Country:US
Practice Address - Phone:407-351-6682
Practice Address - Fax:407-345-8389
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
FLME83639207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G65683Medicare UPIN