Provider Demographics
NPI:1487014858
Name:GERSEY, ZACHARY CHARLES
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:CHARLES
Last Name:GERSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 NW 1ST AVE
Mailing Address - Street 2:APT H2611
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-3541
Mailing Address - Country:US
Mailing Address - Phone:321-626-6730
Mailing Address - Fax:
Practice Address - Street 1:915 NW 1ST AVE
Practice Address - Street 2:APT H2611
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-3541
Practice Address - Country:US
Practice Address - Phone:321-626-6730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program