Healthcare Provider Details

I. General information

NPI: 1861559346
Provider Name (Legal Business Name): DAVID S. GEISER, PH.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 04/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 COURTNEY DR SUITE 2
FORT MYERS FL
33901-9034
US

IV. Provider business mailing address

1950 COURTNEY DR SUITE 2
FORT MYERS FL
33901-9034
US

V. Phone/Fax

Practice location:
  • Phone: 239-278-3231
  • Fax: 239-278-4227
Mailing address:
  • Phone: 239-278-3231
  • Fax: 239-278-4227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY0005048
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY0005048
License Number StateFL

VIII. Authorized Official

Name: DR. DAVID S GEISER
Title or Position: PRESIDENT OF P.A.
Credential: PH.D.
Phone: 239-278-3231