Healthcare Provider Details

I. General information

NPI: 1720167216
Provider Name (Legal Business Name): RENE PRZKORA M.D., PH.D., MMS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 11/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD DEP OF ANESTHESIOLOGY, U OF FLORIDA COLLEGE OF MEDICINE
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

3700 WINDMEADOWS BLVD APT V228
GAINESVILLE FL
32608-0418
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0077
  • Fax:
Mailing address:
  • Phone: 409-771-8232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License NumberTRN-9930
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME 103558
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number242423
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: