Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PO3086 | FL |
Y | 222Z00000X | Podiatrist | PO3086 | FL |
N | 213EP1101X | Primary Podiatric Medicine | PO3086 | FL |
NPI | 1073532198 |
---|---|
Provider Name | Dr. Lena A Georges |
First Address | Tampa, FL 33609-4039 |
Second Address | Tampa, FL 33609-4039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 05/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
340436600 | (05) | FL |
65828 | BLUE CROSS BLUE SHIELD (01) | FL |
P00085644 | RAILROAD MEDICARE (01) | |
U44944 | (02) |