Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | ME80765 | FL |
NPI | 1003841925 |
---|---|
Provider Name | Dr. Richard Geary |
First Address | Valrico, FL 33594-9245 |
Second Address | Valrico, FL 33594-9245 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00731134 | (05) | GA |
G36893 | (02) |