Provider Demographics
NPI:1154820298
Name:GEYER MARTIN, MARTA R
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:R
Last Name:GEYER MARTIN
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 1:8521 N TAMPA ST
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-1349
Mailing Address - Country:US
Mailing Address - Phone:786-379-3252
Mailing Address - Fax:
Practice Address - Street 1:8521 N TAMPA ST
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604-1349
Practice Address - Country:US
Practice Address - Phone:786-379-3252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-05
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician