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General NPI Number Information
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NPI Number | 1629096540
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Entity Type | Organization
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Legal Business Name | GEORGIS PATSIAS MD PA
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 08/15/2007
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Provider Practice Location Address
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Address Line | 1397 MEDICAL PARK BLVD SUITE 260
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City | WELLINGTON
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State | FL
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Zip | 33414-6108
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Country | US
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Telephone | 561-753-3787
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Fax | 561-753-3793
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Provider Business Mailing Address
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Address Line | 1397 MEDICAL PARK BLVD SUITE 260
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City | WELLINGTON
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State | FL
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Zip | 33414-6108
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Country | US
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Telephone | 561-753-3787
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Fax | 561-753-3793
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Authorized Official
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Title or Position | OWNER
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Name | GEORGIS PATISIAS
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Credential | M.D.
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Telephone | 561-753-3787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | ME0049282
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License Number State | FL
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