Provider Demographics
NPI:1215214382
Name:GEERS, ANDREW WILLIAM (PA-C, ATC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:WILLIAM
Last Name:GEERS
Suffix:
Gender:M
Credentials:PA-C, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13715 WATERHOUSE WAY
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-8349
Mailing Address - Country:US
Mailing Address - Phone:813-789-4206
Mailing Address - Fax:
Practice Address - Street 1:596 OCOEE COMMERCE PKWY
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4219
Practice Address - Country:US
Practice Address - Phone:407-654-3505
Practice Address - Fax:407-654-4956
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL31932255A2300X
FLPA9109056363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer