Provider Demographics
NPI:1790892453
Name:GERBER, MARC R (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:R
Last Name:GERBER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1507 S HIAWASSEE RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32835-5718
Mailing Address - Country:US
Mailing Address - Phone:407-822-8875
Mailing Address - Fax:407-822-8814
Practice Address - Street 1:1507 S HIAWASSEE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5718
Practice Address - Country:US
Practice Address - Phone:407-822-8875
Practice Address - Fax:407-822-8814
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0070738208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL31252Medicare ID - Type Unspecified
FLG29969Medicare UPIN