Provider Demographics
NPI:1083812994
Name:VARLAKOV, GRIGOR (MD)
Entity Type:Individual
Prefix:DR
First Name:GRIGOR
Middle Name:
Last Name:VARLAKOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-3833
Mailing Address - Country:US
Mailing Address - Phone:352-277-5348
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:92 CYPRESS BLVD W
Practice Address - Street 2:
Practice Address - City:HOMOSASSA
Practice Address - State:FL
Practice Address - Zip Code:34446-4562
Practice Address - Country:US
Practice Address - Phone:352-382-0258
Practice Address - Fax:352-382-0416
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08203400207Q00000X
FLME99046207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000643600Medicaid
FL08305OtherBCBS OF FL