Provider Demographics
NPI:1144205907
Name:ARMENAKIS, GUS (MD)
Entity Type:Individual
Prefix:DR
First Name:GUS
Middle Name:
Last Name:ARMENAKIS
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 1:7421 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-2977
Mailing Address - Country:US
Mailing Address - Phone:954-721-8945
Mailing Address - Fax:954-721-8946
Practice Address - Street 1:7421 N UNIVERSITY DR
Practice Address - Street 2:SUITE 306
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2977
Practice Address - Country:US
Practice Address - Phone:954-721-8945
Practice Address - Fax:954-721-8946
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME89221207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL48077YMedicare PIN
FLI09779Medicare UPIN