Organization
PLAZA DE LA SALUD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERARDO FELICIANO M.D (MEMBER)
(239) 314-4600
Entity
Organization
Contact information
Practice address
2635 BOGGY CREEK RD, KISSIMMEE, FL 34744-4101
(239) 314-4600
Mailing address
2635 BOGGY CREEK RD, KISSIMMEE, FL 34744-4101
(239) 314-4600
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
ME105191
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942283429
DR GERARDO FELICIANO NPI
FL
01
—
4240180
CIGNA
FL
01
—
DE030Y
MEDICARE PTAN DR FELICIANO
FL
01
—
EZ306A
MEDICARE PTAN PLAZA DE LA SALUD
FL
Enumeration date
10/25/2010
Last updated
08/05/2011
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