Individual
DR. GREGORY JAMES PIACENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1106 HOSPITAL ROAD, NEUROLOGY DEPARTMENT, FORT WALTON BEACH, FL 32547
(850) 863-8253
(850) 863-7045
Mailing address
1106 HOSPITAL ROAD, NEUROSCIENCE CENTER, FORT WALTON BEACH, FL 32547
(850) 863-8253
(850) 863-7045
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME63890
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18816
BCBSFL
FL
05
—
372892700
—
FL
Enumeration date
12/15/2005
Last updated
01/16/2017
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