MEDICARE: DR. JONETTE ELIZABETH KERI M.D., PH. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	ME78553	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053396150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONETTE ELIZABETH KERI M.D., PH. D.

Provider Business Mailing Address
First Line	:	1600 NW 10TH AVE
Second Line	:	ROOM 2023A (R-250)
City	:	MIAMI
State	:	FL
Zip	:	33136-1015
Country	:	US
Telephone Number	:	305-243-4472
Fax Number	:	305-243-6191

Provider Business Practice Location Address
First Line	:	1600 NW 10TH AVE
Second Line	:	ROOM 2023A (R-250)
City	:	MIAMI
State	:	FL
Zip	:	33136-1015
Country	:	US
Telephone Number	:	305-243-4472
Fax Number	:	305-243-6191

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2005
Last Update Date	:	02/13/2015

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