Healthcare Provider Details

I. General information

NPI: 1508052507
Provider Name (Legal Business Name): WILLIAM D. GIESEKE, MDPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2007
Last Update Date: 09/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5130 LINTON BLVD SUITE B-2
DELRAY BEACH FL
33484-6596
US

IV. Provider business mailing address

5130 LINTON BLVD SUITE B-2
DELRAY BEACH FL
33484-6596
US

V. Phone/Fax

Practice location:
  • Phone: 561-499-8025
  • Fax: 561-496-7949
Mailing address:
  • Phone: 561-499-8025
  • Fax: 561-496-7949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM D GIESEKE
Title or Position: OWNER
Credential: MD
Phone: 561-499-8025