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General NPI Number Information
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NPI Number | 1003059825
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Entity Type | Individual
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Provider Name | GEORGE PATOUNAKIS M.D,
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Gender | Male
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Dates
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Enumeration Date | 04/08/2009
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Last Update Date | 01/16/2017
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Provider Practice Location Address
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Address Line | 400 COLONIAL CENTER PKWY SUITE 150
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City | LAKE MARY
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State | FL
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Zip | 32746-7682
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Country | US
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Telephone | 407-804-9670
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Fax | 407-804-9671
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Provider Business Mailing Address
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Address Line | 400 COLONIAL CENTER PKWY SUITE 150
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City | LAKE MARY
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State | FL
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Zip | 32746-7682
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Country | US
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Telephone | 407-804-9670
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Fax | 407-804-9671
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | ME126268
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | ME126268
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License Number State | FL
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