MEDICARE: F GARY GIESEKE MD PA

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	207T00000X	Neurological Surgery Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962499160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	F GARY GIESEKE MD PA

Provider Business Mailing Address
First Line	:	1821 NE 25TH ST STE 101
Second Line	:
City	:	LIGHTHOUSE POINT
State	:	FL
Zip	:	33064-7744
Country	:	US
Telephone Number	:	954-771-4251
Fax Number	:	954-491-4892

Provider Business Practice Location Address
First Line	:	1821 NE 25TH ST STE 101
Second Line	:
City	:	LIGHTHOUSE POINT
State	:	FL
Zip	:	33064-7744
Country	:	US
Telephone Number	:	954-771-4251
Fax Number	:	954-491-4892

Authorized Official
Title or Position	:	PRESIDENT
Name	:	F GARY GIESEKE
Credential	:	M.D.
Telephone Number	:	954-771-4251

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	03/17/2018

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