George Idiculla MD,PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0066869 Issued in FL

Legal business name

GEORGE IDICULLA MD,PA

Practice address

1029 Florida Ave S
Rockledge, FL 32955-2160

Phone

(321) 638-0888

NPI assigned

Feb 8, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. George A Idiculla, M.DNPI 1891806642

Title

President

Phone

(321) 638-0888

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• George A Idiculla, MD

  • Internal Medicine Physician
  • Rockledge, FL
  • NPI 1891806642
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375142400000",
    "number": "1013289859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 FLORIDA AVE S",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552160",
            "telephone_number": "321-638-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 FLORIDA AVE S",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552160",
            "telephone_number": "321-638-0888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE IDICULLA MD,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-08",
        "last_updated": "2013-07-30",
        "status": "A",
        "authorized_official_last_name": "IDICULLA",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-638-0888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0066869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376630600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George Gayle
• Gee Resolutions, Inc.
• Gee Resolutions, Inc.
• Kelly Erin Geisinger, COTA
• Keith Sebastian Gelzinis, RPH
• Brittany George, MSW
• Kellie Dianne Geuting, PT
• Gi Associates of Brevard
• Taylor Roseanne Giambalvo, COTA/L
• Olivia Gibson

• Internal Medicine Physician in Rockledge, FL
• Providers in Rockledge, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.