Healthcare Provider Details

I. General information

NPI: 1285366096
Provider Name (Legal Business Name): THOMAS GERBEC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 NE 191ST ST STE 230
AVENTURA FL
33180-3115
US

IV. Provider business mailing address

1200 BRICKELL BAY DR APT 1405
MIAMI FL
33131-3252
US

V. Phone/Fax

Practice location:
  • Phone: 305-935-4551
  • Fax:
Mailing address:
  • Phone: 614-546-7974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License NumberOT23135
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: