Healthcare Provider Details

I. General information

NPI: 1851593040
Provider Name (Legal Business Name): DAVID KERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NW 10TH AVE SUITE 1114
MIAMI FL
33136-1003
US

IV. Provider business mailing address

1500 NW 12TH AVE JMT EAST 1007
MIAMI FL
33136-1028
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-8644
  • Fax: 305-243-3762
Mailing address:
  • Phone: 305-243-8644
  • Fax: 305-243-3762

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME 101537
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberTRN 9156
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: