Individual
GEORGE WENDELL M. FELICIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
430 MORTON PLANT ST STE 301, CLEARWATER, FL 33756-3395
(727) 461-6026
(727) 461-1492
Mailing address
13020 N TELECOM PKWY, TEMPLE TERRACE, FL 33637-0915
(813) 978-9700
(813) 558-6185
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01061668A
IN
207X00000X
Orthopaedic Surgery Physician
A91695
CA
207X00000X
Orthopaedic Surgery Physician
Primary
ME161089
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000485928
ANTHEM
IN
01
—
000000764488
ANTHEM
IN
05
—
200821830
—
IN
01
—
P01134239
MEDICARE RAILROAD
IN
Enumeration date
01/04/2006
Last updated
06/21/2023
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