Provider Demographics
NPI:1265666945
Name:KLARA GERSHMAN M.D.
Entity Type:Organization
Organization Name:KLARA GERSHMAN M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KLARA
Authorized Official - Middle Name:
Authorized Official - Last Name:GERSHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-673-3555
Mailing Address - Street 1:777 17TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-1895
Mailing Address - Country:US
Mailing Address - Phone:305-673-3555
Mailing Address - Fax:305-673-1960
Practice Address - Street 1:777 17TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-1895
Practice Address - Country:US
Practice Address - Phone:305-673-3555
Practice Address - Fax:305-673-1960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-08
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 39457261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2547473000Medicaid
FL2547473000Medicaid
FLD63810Medicare UPIN