Provider Demographics
NPI:1578804183
Name:KERBLE, RONALD JAY (PA)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:JAY
Last Name:KERBLE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7280 W PALMETTO PARK RD STE 305
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3427
Mailing Address - Country:US
Mailing Address - Phone:561-955-6025
Mailing Address - Fax:561-955-6069
Practice Address - Street 1:7280 W PALMETTO PARK RD STE 305
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3427
Practice Address - Country:US
Practice Address - Phone:561-955-6025
Practice Address - Fax:561-955-6069
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101013363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical