Provider Demographics
NPI:1700248077
Name:SIEGMEISTER, JEROME ARON (MD)
Entity Type:Individual
Prefix:
First Name:JEROME
Middle Name:ARON
Last Name:SIEGMEISTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7712 ALTAMIRA AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33143-6244
Mailing Address - Country:US
Mailing Address - Phone:305-666-7225
Mailing Address - Fax:973-528-1136
Practice Address - Street 1:3850 BIRD RD FL 10
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33146-1501
Practice Address - Country:US
Practice Address - Phone:305-666-7225
Practice Address - Fax:973-528-1136
Is Sole Proprietor?:No
Enumeration Date:2016-03-24
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1421202084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME142120OtherLICENSE