George R Ikeler, M.D P.a.
Organization Active NPI Clinic/Center · Sorrento, FL
NPI 1508097759 · NPPES record last updated Feb 5, 2013
Key facts
- NPI
- 1508097759
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- License
- ME12314 (FL)
- Legal business name
- GEORGE R IKELER, M.D P.A.
- Practice address
- 31450 Church St
Sorrento, FL 32776-9594 - Phone
- (352) 735-4044
- Fax
- (352) 735-2536
- NPI assigned
- Aug 6, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. George Raymond Ikeler, M.D
- Title
- President
- Phone
- (352) 735-4044
National Provider Directory
Locations
720 N Bay St
Ste 1850
Eustis, FL 32726
Phone (352) 357-3129
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | ME12314 | FL | Yes |
Addresses
Primary practice location
31450 Church St
Sorrento, FL 32776-9594
Mailing address
31450 Church St
Sorrento, FL 32776-9594
Phone (352) 735-4044
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 043349700 | Medicaid | FL |
Other providers in Sorrento, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.