Healthcare Provider Details

I. General information

NPI: 1063662179
Provider Name (Legal Business Name): GEORGE ANTHONY NEGRETE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2008
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2352 BRUCE B DOWNS BLVD STE 201
WESLEY CHAPEL FL
33544-9203
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 813-788-8160
  • Fax: 813-355-5065
Mailing address:
  • Phone: 239-424-2755
  • Fax: 239-424-2756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME166998
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: