Individual
GEORGE MICHAEL DMYTRENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
5153 N 9TH AVE, PENSACOLA, FL 32504-8785
(850) 416-2554
(850) 416-2536
Mailing address
PO BOX 2699, PENSACOLA, FL 32513-2699
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME0062184
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371074200
—
FL
Enumeration date
08/01/2006
Last updated
06/24/2010
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