Provider Demographics
NPI:1407963101
Name:JANKO, GARY STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:STEVEN
Last Name:JANKO
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:BAY PINES VA HEALTHCARE SYSTEM
Mailing Address - Street 2:PO BOX 5005
Mailing Address - City:BAY PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33744
Mailing Address - Country:US
Mailing Address - Phone:941-355-5117
Mailing Address - Fax:727-319-1003
Practice Address - Street 1:BAY PINES VA HEALTHCARE SYSTEM
Practice Address - Street 2:10000 BAY PINES BOULEVARD
Practice Address - City:BAY PINES
Practice Address - State:FL
Practice Address - Zip Code:33744
Practice Address - Country:US
Practice Address - Phone:941-355-5117
Practice Address - Fax:727-319-1003
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 343872086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery