Provider Demographics
NPI:1417945130
Name:COMPANIONI, GEORGE R (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:R
Last Name:COMPANIONI
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 1:13707 BRUCE B DOWNS BLVD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4647
Mailing Address - Country:US
Mailing Address - Phone:813-977-4767
Mailing Address - Fax:813-977-6275
Practice Address - Street 1:13707 BRUCE B DOWNS BLVD #115
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4647
Practice Address - Country:US
Practice Address - Phone:813-977-4767
Practice Address - Fax:813-977-6275
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0037326207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30674OtherBCBS #
FL068735900Medicaid
FL30674ZMedicare ID - Type UnspecifiedMEDICARE #
FL068735900Medicaid