Provider Demographics
NPI:1801859525
Name:SAROSI, GEORGE ANDREW JR (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ANDREW
Last Name:SAROSI
Suffix:JR
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:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-265-0761
Mailing Address - Fax:352-265-0190
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-265-0761
Practice Address - Fax:352-265-0190
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9166208600000X
FLMFC1605208600000X
FLME103058208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277403800Medicaid
TX046785401Medicaid
TXSA088848NMedicare ID - Type Unspecified
FL277403800Medicaid
F63464Medicare UPIN