Provider Demographics
NPI:1003826645
Name:GEORGIADES, JAMES NICHOLAS (AP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:NICHOLAS
Last Name:GEORGIADES
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:918 ROLLING ACRES RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-5027
Mailing Address - Country:US
Mailing Address - Phone:352-205-8305
Mailing Address - Fax:352-750-1933
Practice Address - Street 1:918 ROLLING ACRES RD
Practice Address - Street 2:SUITE 8
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-5027
Practice Address - Country:US
Practice Address - Phone:352-205-8305
Practice Address - Fax:352-750-1933
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAP2141171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist