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NPI Code Detail

MEDICARE: FRANK EDWARD GREDLER M.D.

MEDICARE: FRANK EDWARD GREDLER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease PhysicianME 54304FL
2207RC0000XCardiovascular Disease Physician042836GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
204619OTHERFLBLUE CROSS BLUE SHIELD
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
401106OTHERFLUNIVERSAL HEALTH CARE
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
600000OTHERGABLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1023013661
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRANK EDWARD GREDLER M.D.
Provider Business Mailing Address
First Line : 1300 MEDICAL DR
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-4646
Country : US
Telephone Number : 850-216-0100
Fax Number : 850-216-0191
Provider Business Practice Location Address
First Line : 1300 MEDICAL DR
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32308-4646
Country : US
Telephone Number : 850-216-0100
Fax Number : 850-216-0191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 07/09/2015

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Directions to “ FRANK EDWARD GREDLER M.D.” Practice Location

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