| George R Ikeler, M.d P.a. | |
|
31450 Church St Sorrento FL 32776-9594 | |
| (352) 735-4044 | |
| (352) 735-2536 |
| Full Name | George R Ikeler, M.d P.a. |
|---|---|
| Speciality | Clinic/Center |
| Location | 31450 Church St, Sorrento, Florida |
| Authorized Official Name and Position | George Raymond Ikeler (PRESIDENT) |
| Authorized Official Contact | 3527354044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| George R Ikeler, M.d P.a. 31450 Church St Sorrento FL 32776-9594 Ph: (352) 735-4044 | George R Ikeler, M.d P.a. 31450 Church St Sorrento FL 32776-9594 Ph: (352) 735-4044 |
| NPI Number | 1508097759 |
|---|---|
| Provider Enumeration Date | 08/06/2009 |
| Last Update Date | 02/05/2013 |
| Medicare PECOS PAC ID | 3375452436 |
|---|---|
| Medicare Enrollment ID | O20090903000453 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508097759 | NPI | - | NPPES |
| 043349700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | ME12314 (Florida) | Primary |
| Provider Name | George R Ikeler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013944933 PECOS PAC ID: 7911816079 Enrollment ID: I20090909000506 |
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