Provider Demographics
NPI:1205919677
Name:FLOREK, GERY (MD)
Entity type:Individual
Prefix:DR
First Name:GERY
Middle Name:
Last Name:FLOREK
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 1:1401 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
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2012-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME520672084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00356815AMedicaid
FL00977460Medicaid
GA00356815AMedicaid
FL07935Medicare ID - Type Unspecified