Provider Demographics
NPI:1649628868
Name:PANJETON, GEOFFREY DANIAL (MD)
Entity type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:DANIAL
Last Name:PANJETON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10335H CROSS CREEK BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2765
Mailing Address - Country:US
Mailing Address - Phone:561-317-3628
Mailing Address - Fax:
Practice Address - Street 1:10335H CROSS CREEK BLVD STE 5
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2765
Practice Address - Country:US
Practice Address - Phone:561-317-3628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021016590207LP2900X
FLME145945207LP2900X, 207L00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program