Provider Demographics
NPI:1376594325
Name:GEER-YAN, LISA M (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:GEER-YAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8431 POINTE LOOP DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34293-2232
Mailing Address - Country:US
Mailing Address - Phone:941-207-5330
Mailing Address - Fax:941-207-5346
Practice Address - Street 1:8431 POINTE LOOP DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34293-2232
Practice Address - Country:US
Practice Address - Phone:941-207-5330
Practice Address - Fax:941-207-5346
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT047058207VG0400X
FLME124443207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLIH957ZMedicare PIN
PA095456Medicare PIN