Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YS0123X | Facial Plastic Surgeon | 25MA09108500 | NJ |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | ME117335 | FL |
NPI | 1649475583 |
---|---|
Provider Name | Dr. David Jesse Gerth JR. |
First Address | Miami, FL 33131-5312 |
Second Address | Miami, FL 33136-2107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2007 |
Last Update Date | 08/05/2016 |