Provider Demographics
NPI:1699417626
Name:GEORGIOU, PETROS T (MD)
Entity type:Individual
Prefix:DR
First Name:PETROS
Middle Name:T
Last Name:GEORGIOU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11645 BISCAYNE BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-3138
Mailing Address - Country:US
Mailing Address - Phone:305-538-8835
Mailing Address - Fax:305-994-0054
Practice Address - Street 1:710 ALTON RD
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-5504
Practice Address - Country:US
Practice Address - Phone:305-538-8835
Practice Address - Fax:305-994-0054
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2025-08-05
Deactivation Date:2023-01-03
Deactivation Code:
Reactivation Date:2023-01-31
Provider Licenses
StateLicense IDTaxonomies
FLME172421207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine