Provider Demographics
NPI:1982895223
Name:PAPANICOLAOU, GEORGE DIMITRIOS (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:DIMITRIOS
Last Name:PAPANICOLAOU
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:3272 W LAKE MARY BLVD STE 1810
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3589
Mailing Address - Country:US
Mailing Address - Phone:407-478-3151
Mailing Address - Fax:407-339-4267
Practice Address - Street 1:3272 W LAKE MARY BLVD STE 1810
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3589
Practice Address - Country:US
Practice Address - Phone:407-478-3151
Practice Address - Fax:407-339-4267
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME859662086S0105X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001633300Medicaid