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General NPI Number Information
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NPI Number | 1629240593
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Entity Type | Organization
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Legal Business Name | SCOTT L. GELLER MD, PA
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Dates
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Enumeration Date | 03/31/2008
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Last Update Date | 01/31/2012
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Provider Practice Location Address
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Address Line | 4755 SUMMERLIN RD SUITE # 1
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City | FORT MYERS
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State | FL
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Zip | 33919-1073
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Country | US
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Telephone | 239-275-8222
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Fax | 239-275-9080
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Provider Business Mailing Address
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Address Line | 4755 SUMMERLIN RD SUITE # 1
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City | FORT MYERS
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State | FL
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Zip | 33919-1073
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Country | US
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Telephone | 239-275-8222
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Fax | 239-275-9080
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. SCOTT L GELLER
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Credential | MD
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Telephone | 239-275-8222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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