Healthcare Provider Details

I. General information

NPI: 1457382178
Provider Name (Legal Business Name): JERRY ROBERT WEXLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 NW 13TH ST SUITE 5D
BOCA RATON FL
33486-2359
US

IV. Provider business mailing address

951 NW 13TH ST SUITE 5D
BOCA RATON FL
33486-2359
US

V. Phone/Fax

Practice location:
  • Phone: 561-392-2099
  • Fax: 561-392-7155
Mailing address:
  • Phone: 561-392-7266
  • Fax: 561-392-7155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME26617
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: