George J Haedicke, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

ME0052210 Issued in FL

Practice address

4600 N Habana Ave
Suite 22
Tampa, FL 33614-7123

Phone

(813) 874-7529

Fax

(813) 879-1961

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750475919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 N HABANA AVE",
            "address_2": "SUITE 22",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147123",
            "telephone_number": "813-874-7529",
            "fax_number": "813-879-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 N HABANA AVE",
            "address_2": "SUITE 22",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147123",
            "telephone_number": "813-874-7529",
            "fax_number": "813-879-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAEDICKE",
        "first_name": "GEORGE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0052210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wedad Haddabeh, PHARMD
• Walid Haddad, MD
• Patricia Hadders, M.S., CF-SLP
• Bo Haddle, COTA
• Anna E Hadid, M.D.
• Breeanna Linn Hafeli
• Yasmeen Christopher Hafer
• Osama Ibrahim Hafez, MD
• John Michael Haffey, DO
• George Leslie Haffner, OD

• Specialist in Tampa, FL
• Providers in Tampa, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.