Provider Demographics
NPI:1912932153
Name:MUELLER, GEORGE LESTER (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:LESTER
Last Name:MUELLER
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 1:2800 S SEACREST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32435
Mailing Address - Country:US
Mailing Address - Phone:561-736-8200
Mailing Address - Fax:561-853-1608
Practice Address - Street 1:2800 S SEACREST
Practice Address - Street 2:SUITE 200
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32435
Practice Address - Country:US
Practice Address - Phone:561-736-8200
Practice Address - Fax:561-853-1608
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00401552086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL61220OtherBC
D57145Medicare UPIN
FL61220BMedicare PIN