Provider Demographics
NPI:1033582028
Name:MARCELO M. GHERSI, M.D., P.A.
Entity Type:Organization
Organization Name:MARCELO M. GHERSI, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCELO
Authorized Official - Middle Name:
Authorized Official - Last Name:GHERSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-446-7700
Mailing Address - Street 1:550 BILTMORE WAY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5730
Mailing Address - Country:US
Mailing Address - Phone:305-446-7700
Mailing Address - Fax:
Practice Address - Street 1:550 BILTMORE WAY
Practice Address - Street 2:SUITE 120
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5730
Practice Address - Country:US
Practice Address - Phone:305-446-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-12
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME97357208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty