Healthcare Provider Details

I. General information

NPI: 1306360094
Provider Name (Legal Business Name): GEORGE GULENAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2017
Last Update Date: 07/21/2022
Certification Date: 03/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3090 CARUSO CT STE 20
ORLANDO FL
32806-8510
US

IV. Provider business mailing address

3090 CARUSO CT STE 20
ORLANDO FL
32806-8510
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-5236
  • Fax: 407-426-7443
Mailing address:
  • Phone: 321-841-5236
  • Fax: 407-426-7443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME144767
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: