Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | ME 0050779 | FL |
NPI | 1124091202 |
---|---|
Provider Name | Dr. Keith Jay Lerner |
First Address | Lauderdale Lakes, FL 33313-7261 |
Second Address | Lauderdale Lakes, FL 33313-7261 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 25/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C02551 | (02) |