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NPI Code Detail

MEDICARE: DR. MARCELO M GHERSI M.D.

MEDICARE:  DR. MARCELO M GHERSI  M.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
1208200000XPlastic Surgery PhysicianME97357FL

General Provider Information

NPI Number : 1134340565
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARCELO M GHERSI M.D.
Provider Business Mailing Address
First Line : 100 SE 15TH AVE
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33301-3908
Country : US
Telephone Number : 305-781-0261
Fax Number :
Provider Business Practice Location Address
First Line : 100 SE 15TH AVE
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33301-3908
Country : US
Telephone Number : 305-781-0261
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2007
Last Update Date : 02/04/2009

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