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NPI Code Detail

MEDICARE: DR. GEORGE TJAMALOUKAS D.P.M.

MEDICARE: DR. GEORGE TJAMALOUKAS D.P.M.
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
1213ES0103XFoot & Ankle Surgery PodiatristPO3177FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00657665OTHERFLRAIROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1871510719
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE TJAMALOUKAS D.P.M.
Provider Business Mailing Address
First Line : 2716 STONEWOOD PARK LOOP
Second Line :
City : LAND O LAKES
State : FL
Zip : 34638-6213
Country : US
Telephone Number : 813-909-0865
Fax Number :
Provider Business Practice Location Address
First Line : 2716 STONEWOOD PARK LOOP
Second Line :
City : LAND O LAKES
State : FL
Zip : 34638-6213
Country : US
Telephone Number : 813-909-0865
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2006
Last Update Date : 09/03/2020

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