Provider Demographics
NPI:1205097896
Name:FLOREZ, GERSON BRUCE (MD)
Entity type:Individual
Prefix:
First Name:GERSON
Middle Name:BRUCE
Last Name:FLOREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3066 SW MARTIN DOWNS BLVD
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-2683
Mailing Address - Country:US
Mailing Address - Phone:772-781-2735
Mailing Address - Fax:
Practice Address - Street 1:2150 SE SALERNO RD STE 110
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-6572
Practice Address - Country:US
Practice Address - Phone:772-781-2735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME147331207X00000X, 207XS0106X
PAMD444776207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
358064F4DMedicare PIN