Provider Demographics
NPI:1871862862
Name:GERGER-FAILLERES, PA
Entity Type:Organization
Organization Name:GERGER-FAILLERES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGUERITE
Authorized Official - Middle Name:
Authorized Official - Last Name:GERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-441-8110
Mailing Address - Street 1:326 N BELCHER RD STE A
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33765-2635
Mailing Address - Country:US
Mailing Address - Phone:727-441-8110
Mailing Address - Fax:727-441-8646
Practice Address - Street 1:326 N BELCHER RD
Practice Address - Street 2:STE A
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33765-2635
Practice Address - Country:US
Practice Address - Phone:727-441-8110
Practice Address - Fax:727-441-8646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0005822261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service