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General NPI Number Information
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NPI Number | 1487330916
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Entity Type | Individual
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Provider Name | ROBERT GHERMAN DMD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 11645 BEACH BLVD STE 110
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City | JACKSONVILLE
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State | FL
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Zip | 32246-8482
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Country | US
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Telephone | 904-901-9411
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Fax |
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Provider Business Mailing Address
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Address Line | 12750 JOSSLYN LN
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City | JACKSONVILLE
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State | FL
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Zip | 32246-2292
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Country | US
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Telephone | 702-927-7278
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 28288
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License Number State | FL
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