GEOFFREY LAKE RISLEY (NPI# 1578565735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578565735 |
| Entity Type | Individual |
| Full Name | GEOFFREY LAKE RISLEY |
| Credential | M.D. |
| Practice Address |
5149 N 9th Ave Ste 120 Pensacola FL 32504-8734 |
| Mailing Address |
Po Box 11982 Pensacola FL 32524-1982 |
| Practice Telephone | 8504791805 |
| Practice Fax Number | 8504791829 |
| Mailing Telephone | 8504791805 |
| Mailing Fax Number | 8504799182 |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2019-05-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
ME83348 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 263422800 | 05 | |
| MEDICARE RAILROAD | P00023613 | 01 |
| Street Address |
5149 N 9TH AVE STE 120 |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32504-8734 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679117451 | Mario Gardner | Registered Nurse | 5149 N 9th Ave Ste 120, Pensacola, FL 32504-8734 | 2019-11-04 |
| 1528613734 | Colby Keith Sullivan | Nurse Practitioner | 5149 N 9th Ave Ste 120, Pensacola, FL 32504-8734 | 2019-08-05 |
| 1780183624 | Christine Ann Dickson | Nurse Practitioner | 5149 N 9th Ave Ste 120, Pensacola, FL 32504-8734 | 2018-02-06 |
| 1598180903 | Tonya L Hayes | Physician Assistant | 5149 N 9th Ave Ste 120, Pensacola, FL 32504-8734 | 2014-02-21 |
| 1679843080 | Stephanie Nicole Hunter | Nurse Practitioner | 5149 N 9th Ave Ste 120, Pensacola, FL 32504-8734 | 2012-01-03 |
| 1417274135 | Rebekka Annalisa Accardo | Nurse Practitioner | 5149 N 9th Ave Ste 120, Pensacola, FL 32504-8734 | 2010-04-21 |
| 1215164108 | Shonak Bipin Patel | Surgery | 5149 N 9th Ave Ste 120, Pensacola, FL 32504-8734 | 2009-06-17 |
| 1578727913 | Kristina Renee Adam | Physician Assistant | 5149 N 9th Ave Ste 120, Pensacola, FL 32504-8734 | 2008-07-15 |
| 1255531356 | Morgan F White | Physician Assistant | 5149 N 9th Ave Ste 120, Pensacola, FL 32504-8734 | 2007-07-18 |
| 1821204983 | Christopher J Lecroy | Surgery | 5149 N 9th Ave Ste 120, Pensacola, FL 32504-8734 | 2007-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659978393 | Quinyatta Stride | Behavior Technician | 2511 Creighton Rd., Pensacola, FL 32504 | 2020-10-06 |
| 1962017657 | Pt Solutions of Pensacola LLC | Occupational Therapist | 2114 Creighton Rd, Ste C, Pensacola, FL 32504 | 2020-09-10 |
| 1982226742 | Elevate Behavioral Solutions | Behavioral Analyst | 4045 Renoir St, Pensacola, FL 32504 | 2020-05-14 |
| 1760021349 | Veteran Evaluations of Florida | Internal Medicine | 2411 Executive Plaza Drive, Suite A, Pensacola, FL 32504 | 2019-12-31 |
| 1215575527 | First City Health LLC | Pharmacy | 6005 College Parkway, Suite 1, Pensacola, FL 32504 | 2019-12-17 |
| 1184261158 | Claire Ann Letendre | Audiologist | 5153 N 9th Ave Pediatric Off Building, Pensacola, FL 32504 | 2019-12-09 |
| 1083275101 | Benjamin Mcmillon | Chiropractor | 2629 Creighton Road, Suite 1, Pensacola, FL 32504 | 2019-06-28 |
| 1407342595 | Faryal Munir | Student in an Organized Health Care Education/Training Program | Uf Pediatric Residency 5151 North 9th Ave, 6th Floor Nemours, Pensacola, FL 32504 | 2018-07-02 |
| 1497252050 | Sibyl Tenille Page | Nurse Practitioner | 5147 N 9th Ave Ste 322, Pensacola, FL 32504 | 2018-04-10 |
| 1396272589 | Sacred Heart Hospital | General Acute Care Hospital | 2552 Carmel Heights Rd, Pensacola, FL 32504 | 2017-05-18 |
| Find all providers in zip 32504 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447406582 | John A Tucker M D P A | Surgery | 1717 N E Street, Suite 524, Pensacola, FL 32501-6339 | 2008-08-08 |
| 1790760478 | Fernando E. Kafie | Surgery | 5147 N 9th Ave Ste G21, Pensacola, FL 32504-8771 | 2005-12-14 |
| 1861929606 | John A Tucker Md Pa | Surgery | 8333 N Davis Hwy, 10th Floor, Pensacola, FL 32514-6050 | 2017-05-11 |
| 1215164108 | Shonak Bipin Patel | Surgery | 5149 N 9th Ave Ste 120, Pensacola, FL 32504-8734 | 2009-06-17 |
| 1053504308 | Mark Edward Lytle | Surgery | 5149 N 9th Ave, Suite 120, Pensacola, FL 32504-8756 | 2007-08-21 |
| 1821204983 | Christopher J Lecroy | Surgery | 5149 N 9th Ave Ste 120, Pensacola, FL 32504-8734 | 2007-05-15 |
| 1710905807 | Huey Barrett Mcdaniel | Surgery | 5149 N 9th Ave Ste 120, Pensacola, FL 32504-8734 | 2006-07-17 |
| 1063407567 | John A Tucker | Surgery | 8333 N Davis Hwy, Floor, Pensacola, FL 32514-6050 | 2005-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104394857 | George Scott Hall Sr. | Surgery | 9 Marsh Creek Rd, Fernandina Beach, FL 32034-6413 | 2018-11-09 |
| 1316413115 | Fox Vascular Experts, LLC | Surgery | 2699 Stirling Rd Ste A301302, Fort Lauderdale, FL 33312-6517 | 2018-10-18 |
| 1114417508 | Vascular Center of Naples Inc. | Surgery | 5490 Bryson Dr Ste 201, Naples, FL 34109 | 2018-05-11 |
| 1598267593 | Joseph D Stillword, Md | Surgery | 800 Zeagler Dr Ste 320, Palatka, FL 32177-3827 | 2018-03-06 |
| 1386157006 | Beatriz Lam | Surgery | 2001 West 68 St, Cvicu, Hialeah, FL 33016 | 2017-11-16 |
| 1811421092 | Sunrise Vascular Center | Surgery | 8555 Nw 165th Ter, Miami Lakes, FL 33016-6138 | 2017-04-14 |
| 1962891838 | Global Trauma Systems, Inc | Surgery | 126 Se Mira Lavella, Port Saint Lucie, FL 34984-6615 | 2015-01-15 |
| 1184013450 | Vas-q-lar, Inc | Surgery | 6187 Nw 167th St, Suite H13, Hialeah, FL 33015-4340 | 2015-01-09 |
| 1396147138 | Usa Vein Clinics of Miami, LLC | Surgery | 1711 E Hallandale Beach Blvd Ste B, Hallandale Beach, FL 33009-4621 | 2014-09-24 |
| 1114336021 | Florida Vein Center, Inc | Surgery | 6050 53rd Ave E Unit A, Bradenton, FL 34203-9700 | 2014-08-05 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on GEOFFREY LAKE RISLEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.