Individual
GEORGE B. ANTONIOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1619 CREIGHTON RD, PENSACOLA, FL 32504-7152
(850) 444-4700
(850) 444-7497
Mailing address
PO BOX 11037, PENSACOLA, FL 32524-1037
(850) 444-4700
(850) 444-7497
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME82874
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009935446
—
AL
01
—
01187
BLUE CROSS BLUE SHIELD
FL
05
—
261961000
—
FL
01
—
591-83784
BLUE CROSS BLUE SHIELD
AL
01
—
7167253
AETNA
—
Enumeration date
12/16/2005
Last updated
07/01/2025
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