MEDICARE: LISA M GEER-YAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	047058	CT
2	207VG0400X	Gynecology Physician	ME124443	FL

General Provider Information

NPI Number	:	1376594325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA M GEER-YAN M.D.

Provider Business Mailing Address
First Line	:	8431 POINTE LOOP DR
Second Line	:	2ND FLOOR
City	:	VENICE
State	:	FL
Zip	:	34293-2232
Country	:	US
Telephone Number	:	941-207-5330
Fax Number	:	941-207-5346

Provider Business Practice Location Address
First Line	:	8431 POINTE LOOP DR
Second Line	:	2ND FLOOR
City	:	VENICE
State	:	FL
Zip	:	34293-2232
Country	:	US
Telephone Number	:	941-207-5330
Fax Number	:	941-207-5346

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	11/13/2015

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