Idiculla, George A
Idiculla, George A is an sole proprietor health care provider with primary practice located at 1029 Florida Ave S , Rockledge FL 32955-2160. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Idiculla, George A can be contacted via phone (321) 638-0888.Contact Information
Primary practice address
1029 Florida Ave S
Rockledge FL 32955-2160
Phone: (321) 638-0888
Fax: (321) 638-0830
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ME0066869 | Florida |
Profile Details
| NPI number | 1891806642 |
|---|---|
| LBN Legal business name | Idiculla, George A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 31st, 2006 |
| Last updated | Jul 30th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891806642 | NPPES |
| Florida | MEDICAID | 376630600 |
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