Provider Demographics
NPI:1417969965
Name:GERO, MICHELE L (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:L
Last Name:GERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:415 COMMERCIAL CT STE C
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-1654
Mailing Address - Country:US
Mailing Address - Phone:941-800-1630
Mailing Address - Fax:941-800-1631
Practice Address - Street 1:415 COMMERCIAL CT STE C
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1654
Practice Address - Country:US
Practice Address - Phone:941-800-1630
Practice Address - Fax:941-800-1631
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT042571207Q00000X
FLME111246207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTI20781Medicare UPIN