MEDICARE: DR. PAUL GERCZUK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	ME123662	FL
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	ME123662	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619291994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL GERCZUK MD

Provider Business Mailing Address
First Line	:	38135 MARKET SQ
Second Line	:
City	:	ZEPHYRHILLS
State	:	FL
Zip	:	33542-7505
Country	:	US
Telephone Number	:	352-567-0188
Fax Number	:

Provider Business Practice Location Address
First Line	:	14320 BRUCE B DOWNS BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-2601
Country	:	US
Telephone Number	:	813-280-8181
Fax Number	:	813-377-1679

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2010
Last Update Date	:	07/10/2020

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