Provider Demographics
NPI:1730256934
Name:SYPERT, GEORGE W (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:W
Last Name:SYPERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:12700 CREEKSIDE LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-3356
Mailing Address - Country:US
Mailing Address - Phone:239-432-0774
Mailing Address - Fax:239-432-9404
Practice Address - Street 1:12700 CREEKSIDE LN
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-3356
Practice Address - Country:US
Practice Address - Phone:239-432-0774
Practice Address - Fax:239-432-9404
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME22196207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD57746Medicare UPIN