Provider Demographics
NPI:1508833757
Name:GAMOURAS, GEORGE A (MD FAAC)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:GAMOURAS
Suffix:
Gender:M
Credentials:MD FAAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6376 PINE RIDGE RD STE 380
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-3905
Mailing Address - Country:US
Mailing Address - Phone:239-304-9720
Mailing Address - Fax:239-304-9609
Practice Address - Street 1:6376 PINE RIDGE RD STE 380
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-3905
Practice Address - Country:US
Practice Address - Phone:239-304-9720
Practice Address - Fax:239-304-9609
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69168207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060063855OtherMEDICARE RR
FL49626OtherBCBS
FL060063855OtherMEDICARE RR
FL49626OtherBCBS