Healthcare Provider Details

I. General information

NPI: 1225246895
Provider Name (Legal Business Name): PHILIP GEORGE MD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 SW 137TH AVE STE 111
MIAMI FL
33186-1435
US

IV. Provider business mailing address

9000 SW 137TH AVE STE 111
MIAMI FL
33186-1435
US

V. Phone/Fax

Practice location:
  • Phone: 305-388-3660
  • Fax: 305-388-5993
Mailing address:
  • Phone: 305-388-3660
  • Fax: 305-388-5993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: PHILIP GEORGE
Title or Position: PRESIDENT
Credential: MD
Phone: 305-388-3660