Gregg Shore (NPI# 1235138983, PAC ID# 9537122205) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is COLORECTAL SURGERY (PROCTOLOGY).
| Nation Provider ID (NPI) | 1235138983 |
| PAC ID by PECOS | 9537122205 |
| Professional Enrollment ID | I20041104000772 |
| Full Name | Gregg Shore |
| Organization Legal Name | FLORIDA LAKES SURGICAL PLLC |
| Address |
4759 Lakeview Dr Suite 101 Sebring FL 33870-2005 |
| Phone Number | 8634025600 |
| Gender | M |
| Credential | MD |
| Graduation Year | 1989 |
| Primary Specialty | COLORECTAL SURGERY (PROCTOLOGY) |
| Secondary Specialties | GENERAL SURGERY |
| Group Practice PAC ID | 9537256110 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100049 | HIGHLANDS REGIONAL MEDICAL CENTER |
| 100109 | FLORIDA HOSPITAL HEARTLAND MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 4759 Lakeview Dr, Suite 101, Sebring, FL 33870-2005 | 8634025600 | FLORIDA LAKES SURGICAL PLLC |
| Organization Legal Name | FLORIDA LAKES SURGICAL PLLC |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomas C Lackey Ii | General Surgery | Florida Lakes Surgical Pllc | 4759 Lakeview Dr, Suite 101, Sebring, FL 33870-2005 |
| Street Address |
4759 LAKEVIEW DR SUITE 101 |
| City | SEBRING |
| State | FL |
| Zip | 33870-2005 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomas C Lackey Ii | General Surgery | Florida Lakes Surgical Pllc | 4759 Lakeview Dr, Suite 101, Sebring, FL 33870-2005 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mark A Ashby | Psychiatry | Mark A Ashby Md Pa | 2821 Alternate Us 27, Sebring, FL 33870 |
| Ray H Tangunan | General Practice | 6801 Us Hwy 27 N B4, Sebring, FL 33870 | |
| Ernesto Pinzon | Nephrology | 2950 Alt Us Hwy 27 S, Suite A, Sebring, FL 33870 | |
| Michael Eric Sanders | Nurse Practitioner | Mark A Ashby Md Pa | 2821 Alternate Us 27, Sebring, FL 33870 |
| John Mcneal | Clinical Social Worker | Mark A Ashby Md Pa | 2821 Alternate Us 27, Sebring, FL 33870 |
| Mary Louise Hudson Ray | Nurse Practitioner | Mark A Ashby Md Pa | 2821 Alternate Us 27, Sebring, FL 33870 |
| Ronald V Fronda | Internal Medicine | Ernesto Pinzon Pa | 2950 Alt Us Hwy 27 S, Suite A, Sebring, FL 33870 |
| Dipakkumar M Upadhyaya | Obstetrics/gynecology | 6801 Us 27, Suite A 1, Sebring, FL 33870-1000 | |
| Anthony J Arciola | Urology | 6801 Us 27 N, C2, Sebring, FL 33870-1000 | |
| Bridglal Ramkissoon | Neurology | 6801 Us 27, Suite A3, Sebring, FL 33870-1000 | |
| Find all physicians in zip 33870 | |||
| City | SEBRING |
| Zip Code | 33870 |
| Specialty | COLORECTAL SURGERY (PROCTOLOGY) |
| City + Specialty | SEBRING + COLORECTAL SURGERY (PROCTOLOGY) |
Please comment or provide details below to improve the information on Gregg Shore.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.