Healthcare Provider Details

I. General information

NPI: 1609820166
Provider Name (Legal Business Name): EDGAR J GEIGEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 05/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13800 VETERANS WAY SUITE 2G
ORLANDO FL
32827-7401
US

IV. Provider business mailing address

13800 VETERANS WAY SUITE 2G
ORLANDO FL
32827-7401
US

V. Phone/Fax

Practice location:
  • Phone: 407-631-1000
  • Fax: 407-513-9695
Mailing address:
  • Phone: 407-631-1000
  • Fax: 407-513-9695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME77611
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: