Provider Demographics
NPI:1205127883
Name:MARIANNE GERACI M D PLLC
Entity type:Organization
Organization Name:MARIANNE GERACI M D PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GERACI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-963-9827
Mailing Address - Street 1:PO BOX 112710
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-0146
Mailing Address - Country:US
Mailing Address - Phone:239-963-9827
Mailing Address - Fax:239-963-9854
Practice Address - Street 1:5185 CASTELLO DR
Practice Address - Street 2:SUITE 2
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-8903
Practice Address - Country:US
Practice Address - Phone:239-963-9827
Practice Address - Fax:239-963-9854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-29
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME91929207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEY683AMedicare PIN