Healthcare Provider Details

I. General information

NPI: 1598250631
Provider Name (Legal Business Name): ALEXIS RAE GERTLER D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2018
Last Update Date: 06/08/2025
Certification Date: 06/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2499 GLADES RD STE 102
BOCA RATON FL
33431-7260
US

IV. Provider business mailing address

550 SE MIZNER BLVD APT 806B
BOCA RATON FL
33432-5578
US

V. Phone/Fax

Practice location:
  • Phone: 561-362-6000
  • Fax:
Mailing address:
  • Phone: 516-318-2936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDN27707
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: