Provider Demographics
NPI:1376545665
Name:SINGER, JERRY HERBERT (MD)
Entity Type:Individual
Prefix:
First Name:JERRY
Middle Name:HERBERT
Last Name:SINGER
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 1:2234 COLONIAL BLVD
Mailing Address - Street 2:ATTN: PAYER CONTRACTING & RELATIONS DEPT.
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-1412
Mailing Address - Country:US
Mailing Address - Phone:239-931-7342
Mailing Address - Fax:239-931-7385
Practice Address - Street 1:10115 FOREST HILL BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3105
Practice Address - Country:US
Practice Address - Phone:561-333-1118
Practice Address - Fax:561-333-2228
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42500208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP971657OtherOPTIMUM
FL340003033OtherRR MEDICARE
FL0521542OtherCIGNA
FLP00340OtherFREEDOM
FL041844700Medicaid
FL204298OtherAVMED
FL4091491OtherAETNA
FL61443OtherBC/BS FLORIDA
FLP01616292OtherRR MEDICARE
FL3364OtherDIMENSION HEALTH
FL61443OtherBCBS
FL4091491OtherAETNA
FL61443OtherBCBS
FL041844700Medicaid