Provider Demographics
NPI:1780873596
Name:GEORGE M STOREY, M.D, P.A.
Entity type:Organization
Organization Name:GEORGE M STOREY, M.D, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:STOREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-917-8767
Mailing Address - Street 1:1921 WALDEMERE ST
Mailing Address - Street 2:STE 702
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2913
Mailing Address - Country:US
Mailing Address - Phone:941-917-9867
Mailing Address - Fax:
Practice Address - Street 1:1921 WALDEMERE ST
Practice Address - Street 2:STE 702
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2913
Practice Address - Country:US
Practice Address - Phone:941-917-9867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2008-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0059433207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D30926Medicare UPIN
FL1098250001Medicare NSC