Provider Demographics
NPI:1235164740
Name:GERTH, ELIAS JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIAS
Middle Name:JEFFREY
Last Name:GERTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2819
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33045-2819
Mailing Address - Country:US
Mailing Address - Phone:305-293-7201
Mailing Address - Fax:
Practice Address - Street 1:1501 GOVERNMENT RD
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-5108
Practice Address - Country:US
Practice Address - Phone:305-293-7201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFL 0057437207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C88821Medicare UPIN
12768Medicare PIN