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General NPI Number Information
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NPI Number | 1407406218
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Entity Type | Individual
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Provider Name | GEOFFREY LOUIS SAS
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Gender | Male
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Dates
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Enumeration Date | 09/13/2019
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 1045 KANE CONCOURSE STE 204
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City | BAY HARBOR ISLANDS
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State | FL
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Zip | 33154-2119
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Country | US
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Telephone | 305-916-6061
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Fax |
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Provider Business Mailing Address
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Address Line | 648 N ISLAND
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City | GOLDEN BEACH
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State | FL
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Zip | 33160-2257
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Country | US
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Telephone | 786-202-7475
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN24746
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 060421
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License Number State | NY
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