Provider Demographics
NPI:1366436883
Name:PEKAREK, RICK M (MD)
Entity type:Individual
Prefix:MR
First Name:RICK
Middle Name:M
Last Name:PEKAREK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4601 SPANISH TRL
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-5008
Mailing Address - Country:US
Mailing Address - Phone:850-969-2001
Mailing Address - Fax:850-433-8940
Practice Address - Street 1:4601 SPANISH TRL
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-5008
Practice Address - Country:US
Practice Address - Phone:850-969-2001
Practice Address - Fax:850-433-8940
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 32933207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL64400ZMedicare ID - Type Unspecified
FLD57662Medicare UPIN