Provider Demographics
NPI:1811392228
Name:ELIAS J. GERTH, M.D., FCCM
Entity Type:Organization
Organization Name:ELIAS J. GERTH, M.D., FCCM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIAS
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:GERTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-295-6790
Mailing Address - Street 1:2505 FLAGLER AVE
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-3934
Mailing Address - Country:US
Mailing Address - Phone:305-295-6790
Mailing Address - Fax:305-295-8404
Practice Address - Street 1:2505 FLAGLER AVE
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3934
Practice Address - Country:US
Practice Address - Phone:305-295-6790
Practice Address - Fax:305-295-8404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty