Provider Demographics
NPI:1982231221
Name:GERARD, BERENICE (MD)
Entity Type:Individual
Prefix:
First Name:BERENICE
Middle Name:
Last Name:GERARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 N STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-3103
Mailing Address - Country:US
Mailing Address - Phone:754-732-2177
Mailing Address - Fax:754-732-2225
Practice Address - Street 1:27 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-3103
Practice Address - Country:US
Practice Address - Phone:754-732-2177
Practice Address - Fax:754-732-2225
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME167296207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine