Healthcare Provider Details

I. General information

NPI: 1225316094
Provider Name (Legal Business Name): ALISA NICOLE GEERS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALISA NICOLE FALLOW ARNP

II. Dates (important events)

Enumeration Date: 07/28/2011
Last Update Date: 04/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 FOREST CITY RD
ORLANDO FL
32810-3002
US

IV. Provider business mailing address

110 S WOODLAND ST
WINTER GARDEN FL
34787-3546
US

V. Phone/Fax

Practice location:
  • Phone: 407-905-8827
  • Fax: 407-660-1667
Mailing address:
  • Phone: 407-905-8827
  • Fax: 407-660-1667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9292498
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: