Healthcare Provider Details

I. General information

NPI: 1366427387
Provider Name (Legal Business Name): GEORGE W. RANKIN JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3381 TOWN AVE
NEW PORT RICHEY FL
34655-2168
US

IV. Provider business mailing address

959 RIVERSIDE RIDGE RD
TARPON SPRINGS FL
34688-8801
US

V. Phone/Fax

Practice location:
  • Phone: 727-246-3550
  • Fax: 813-346-3571
Mailing address:
  • Phone: 727-252-8279
  • Fax: 727-293-4119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberME110567
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME110567
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: