Provider Demographics
NPI:1659363455
Name:SHER, JERRY SIDNEY II (MD)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:SIDNEY
Last Name:SHER
Suffix:II
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 1:20601 E DIXIE HWY
Mailing Address - Street 2:SUITE #330
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1540
Mailing Address - Country:US
Mailing Address - Phone:305-674-5956
Mailing Address - Fax:
Practice Address - Street 1:20601 E DIXIE HWY
Practice Address - Street 2:SUITE #330
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1540
Practice Address - Country:US
Practice Address - Phone:305-674-5956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0066762207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26945Medicare ID - Type Unspecified
FLG14875Medicare UPIN