Provider Demographics
NPI:1841564150
Name:GERY K FLOREK MD PA
Entity Type:Organization
Organization Name:GERY K FLOREK MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERY
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOREK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-878-9892
Mailing Address - Street 1:1401 CENTERVILLE RD
Mailing Address - Street 2:SUITE 506
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4647
Mailing Address - Country:US
Mailing Address - Phone:850-878-9892
Mailing Address - Fax:850-877-7801
Practice Address - Street 1:1401 CENTERVILLE RD
Practice Address - Street 2:SUITE 506
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4647
Practice Address - Country:US
Practice Address - Phone:850-878-9892
Practice Address - Fax:850-877-7801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME520672084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00977460Medicaid
GA00356815AMedicaid
FL00977460Medicaid
07935Medicare PIN