Provider Demographics
NPI:1528339314
Name:GEORGI, NINETTE G
Entity type:Individual
Prefix:MRS
First Name:NINETTE
Middle Name:G
Last Name:GEORGI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18910 U S HWY 441
Mailing Address - Street 2:
Mailing Address - City:MT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757
Mailing Address - Country:US
Mailing Address - Phone:352-735-0600
Mailing Address - Fax:352-735-0660
Practice Address - Street 1:18910 US HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-6736
Practice Address - Country:US
Practice Address - Phone:352-735-0600
Practice Address - Fax:352-735-0660
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS434801835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy