Provider Demographics
NPI:1407877376
Name:PANTING, GEORGINA (EDD)
Entity Type:Individual
Prefix:DR
First Name:GEORGINA
Middle Name:
Last Name:PANTING
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1802 N ALAFAYA TRL
Mailing Address - Street 2:SUITE 119
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4716
Mailing Address - Country:US
Mailing Address - Phone:407-992-4452
Mailing Address - Fax:407-482-7578
Practice Address - Street 1:1802 N ALAFAYA TRL
Practice Address - Street 2:SUITE 119
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4716
Practice Address - Country:US
Practice Address - Phone:407-992-4452
Practice Address - Fax:407-482-7578
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9244101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health