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NPI Code Detail

MEDICARE: GARY LEE BADZINSKI DO

MEDICARE: GARY LEE BADZINSKI DO
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
1207RC0000XCardiovascular Disease PhysicianOS9663FL
2207RC0000XCardiovascular Disease Physician2017-00150NC
3207RC0000XCardiovascular Disease Physician3416OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821094327
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY LEE BADZINSKI DO
Provider Business Mailing Address
First Line : 19011 SE OUTRIGGER LN
Second Line :
City : JUPITER
State : FL
Zip : 33458-1083
Country : US
Telephone Number : 918-978-6977
Fax Number :
Provider Business Practice Location Address
First Line : 449 W 23RD ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-4507
Country : US
Telephone Number : 850-769-8341
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 05/06/2025

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Directions to “ GARY LEE BADZINSKI DO” Practice Location

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