Provider Demographics
NPI:1508360967
Name:JEROME, CHRISTOPHER LED'S GISCARD (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LED'S GISCARD
Last Name:JEROME
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 1:4152 W BLUE HERON BLVD STE 126
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-4859
Mailing Address - Country:US
Mailing Address - Phone:561-713-7173
Mailing Address - Fax:
Practice Address - Street 1:4152 W BLUE HERON BLVD STE 126
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-4859
Practice Address - Country:US
Practice Address - Phone:561-713-7173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME148809208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist