Provider Demographics
NPI:1942266002
Name:GERSHMAN, KLARA (MD)
Entity Type:Individual
Prefix:DR
First Name:KLARA
Middle Name:
Last Name:GERSHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 17TH ST
Mailing Address - Street 2:STE 400
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-1895
Mailing Address - Country:US
Mailing Address - Phone:305-673-3555
Mailing Address - Fax:305-673-1960
Practice Address - Street 1:777 17TH ST
Practice Address - Street 2:STE 400
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-1895
Practice Address - Country:US
Practice Address - Phone:305-801-3751
Practice Address - Fax:305-673-1960
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39457207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2547473000Medicaid
FL2547473000Medicaid
FLD63810Medicare UPIN