Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | PO0002468 | FL |
NPI | 1174711204 |
---|---|
Provider Name | Gregory Gerard Cook |
First Address | Sun City Center, FL 33573-6844 |
Second Address | Sun City Center, FL 33573-6844 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2007 |
Last Update Date | 20/07/2021 |