Provider Demographics
NPI:1326071499
Name:GREKOS, ZANNOS GIORGIOS (MD)
Entity Type:Individual
Prefix:MR
First Name:ZANNOS
Middle Name:GIORGIOS
Last Name:GREKOS
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9500 BONITA BEACH RD SE
Mailing Address - Street 2:SUITE 310 REGENCE MEDICAL CENTER
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-4698
Mailing Address - Country:US
Mailing Address - Phone:239-498-9114
Mailing Address - Fax:239-498-6555
Practice Address - Street 1:9500 BONITA BEACH RD SE
Practice Address - Street 2:SUITE 310 REGENCE MEDICAL CENTER
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4698
Practice Address - Country:US
Practice Address - Phone:239-498-9114
Practice Address - Fax:239-498-6555
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0061912207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL250770600Medicaid
G32255Medicare UPIN
FL250770600Medicaid