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General NPI Number Information
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NPI Number | 1609808419
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Entity Type | Individual
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Provider Name | JOHN O GERNERT M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 515 W STATE ROAD 434 SUITE 201
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City | LONGWOOD
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State | FL
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Zip | 32750
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Country | US
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Telephone | 407-745-1115
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Fax | 833-775-1872
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Provider Business Mailing Address
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Address Line | 515 W STATE ROAD 434 SUITE 201
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City | LONGWOOD
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State | FL
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Zip | 32750
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Country | US
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Telephone | 407-745-1115
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Fax | 833-775-1872
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME87839
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | ME87839
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License Number State | FL
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