Risley, Geoffrey Lake

Risley, Geoffrey Lake is an individual health care provider with primary practice located at 5149 N 9Th Ave Ste 120 , Pensacola FL 32504-8734. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Risley, Geoffrey Lake can be contacted via phone (850) 479-1805.

Contact Information

Primary practice address
5149 N 9Th Ave Ste 120 Pensacola FL 32504-8734
Fax: (850) 479-1829
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X ME83348 Florida

Profile Details

NPI number 1578565735
LBN Legal business name Risley, Geoffrey Lake
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated May 22nd, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578565735 NPPES
Florida MEDICAID 263422800
Florida Other P00023613

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