George Idiculla Md,Pa

LBN: George Idiculla Md,Pa
George Idiculla Md,Pa is an health care organization with primary practice located at 1029 Florida Ave S , Rockledge FL 32955-2160. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. George Idiculla Md,Pa can be contacted via phone (321) 638-0888, or through Idiculla, George A via phone (321) 638-0888.

Contact Information

Primary practice address
1029 Florida Ave S Rockledge FL 32955-2160
Phone: (321) 638-0888
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Idiculla, George A Doctor of Medicine (MD)
Phone: (321) 638-0888

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME0066869 Florida

Profile Details

NPI number 1013289859
LBN Legal business name George Idiculla Md,Pa
DBA Doing business as
Authorized official Idiculla, George A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 8th, 2012
Last updated Jul 30th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013289859 NPPES
Florida MEDICAID 376630600

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