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NPI Code Detail

MEDICARE: DR. GEORGE DOUGLAS LETSON M.D.

MEDICARE: DR. GEORGE DOUGLAS LETSON 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
1174400000XSpecialistME0064409FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
212167OTHERFLBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1043280142
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE DOUGLAS LETSON M.D.
Provider Business Mailing Address
First Line : 2503 N DUNDEE ST
Second Line :
City : TAMPA
State : FL
Zip : 33629-6406
Country : US
Telephone Number : 813-745-3976
Fax Number : 813-745-8337
Provider Business Practice Location Address
First Line : 12902 MAGNOLIA DR
Second Line : SUITE 5036
City : TAMPA
State : FL
Zip : 33612-9416
Country : US
Telephone Number : 813-745-3976
Fax Number : 813-745-8337
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2006
Last Update Date : 07/08/2007

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