Organization
FLORIDA NERVE MED LLC
Active
Organization
FLORIDA NERVE MED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HILDEGARDE GEISSE M.D. (OWNER)
(561) 310-7759
Entity
Organization
Contact information
Practice address
8198 S JOG RD, #100, BOYNTON BEACH, FL 33472-2900
(561) 602-6191
(561) 429-3630
Mailing address
741 DUCHESS CT, PALM BEACH GARDENS, FL 33410-1553
(561) 602-6191
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
ME96190
FL
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
ME96190
FL
2084N0400X
Neurology Physician
Primary
ME96190
FL
2084N0600X
Clinical Neurophysiology Physician
ME96190
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME96190
MEDICAL LICENSE
FL
Enumeration date
01/15/2013
Last updated
03/16/2015
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