Provider Demographics
NPI:1073532198
Name:GEORGES, LENA A (DPM)
Entity Type:Individual
Prefix:DR
First Name:LENA
Middle Name:A
Last Name:GEORGES
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 W SWANN AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4039
Mailing Address - Country:US
Mailing Address - Phone:813-876-7073
Mailing Address - Fax:813-879-3737
Practice Address - Street 1:2605 W SWANN AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4039
Practice Address - Country:US
Practice Address - Phone:813-876-7073
Practice Address - Fax:813-879-3737
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3086213EP1101X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65828OtherBLUE CROSS BLUE SHIELD
FL340436600Medicaid
P00085644OtherRAILROAD MEDICARE
FL340436600Medicaid
FLU1447YMedicare PIN