Provider Demographics
NPI:1023354743
Name:GERBER, PHYLLIS ANNETTE (MD)
Entity type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:ANNETTE
Last Name:GERBER
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 1:5036 DR PHILLIPS BLVD STE 333
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-3310
Mailing Address - Country:US
Mailing Address - Phone:941-356-9434
Mailing Address - Fax:941-918-0401
Practice Address - Street 1:1507 S HIAWASSEE RD STE 210
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-5719
Practice Address - Country:US
Practice Address - Phone:407-298-5400
Practice Address - Fax:407-298-8006
Is Sole Proprietor?:No
Enumeration Date:2012-12-28
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 66305202C00000X, 2083P0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical Examiner
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine