Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | ME0053136 | FL |
Y | 207X00000X | Orthopaedic Surgeon | ME0053136 | FL |
NPI | 1093792657 |
---|---|
Provider Name | Richard Gershanik |
First Address | Miami, FL 33144-2039 |
Second Address | Miami, FL 33144-2039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2005 |
Last Update Date | 22/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
048196300 | (05) | FL |
D85819 | (02) | FL |