Provider Demographics
NPI:1932137650
Name:GIANNAKOPOULOS, GEORGE D (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:D
Last Name:GIANNAKOPOULOS
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:PO BOX 5849
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34674-5849
Mailing Address - Country:US
Mailing Address - Phone:727-861-2332
Mailing Address - Fax:727-861-3217
Practice Address - Street 1:13910 FIVAY RD STE 2
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-7130
Practice Address - Country:US
Practice Address - Phone:727-861-2332
Practice Address - Fax:727-378-4669
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME66127174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF81466Medicare UPIN
FL25324YMedicare ID - Type Unspecified