Individual
MR. GREGORY EDWARD LAMENDOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIANS ASST C
Contact information
Practice address
2000 CENTRE POINTE BLVD, TALLAHASSEE, FL 32308-4894
(850) 309-0400
Mailing address
12109 COUNTY ROAD 103, OXFORD, FL 34484-2951
(352) 205-8981
(352) 391-6498
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
PA101919
FL
208800000X
Urology Physician
PA101919
FL
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2911833300
—
FL
Enumeration date
08/31/2006
Last updated
03/17/2021
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