Provider Demographics
NPI:1205099660
Name:GEGAJ, FLORIAN (MD)
Entity type:Individual
Prefix:DR
First Name:FLORIAN
Middle Name:
Last Name:GEGAJ
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 383
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:FL
Mailing Address - Zip Code:34484-0383
Mailing Address - Country:US
Mailing Address - Phone:352-353-0092
Mailing Address - Fax:352-353-0416
Practice Address - Street 1:1050 OLD CAMP RD STE 206
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-1762
Practice Address - Country:US
Practice Address - Phone:352-353-0092
Practice Address - Fax:352-353-0416
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME108826207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFI321YMedicare PIN