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General NPI Number Information
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NPI Number | 1023426509
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Entity Type | Individual
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Provider Name | GREGORY ADAKA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/28/2014
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 9333 SW 152ND ST
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City | PALMETTO BAY
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State | FL
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Zip | 33157-1778
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Country | US
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Telephone | 305-585-4109
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Fax | 305-355-2398
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Provider Business Mailing Address
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Address Line | 8829 CYPRESS PRESERVE PL
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City | FORT MYERS
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State | FL
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Zip | 33912-0829
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Country | US
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Telephone | 603-854-1230
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME133933
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 165030
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License Number State | NH
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