Provider Demographics
NPI:1215988746
Name:TESTERMAN, GERALD DOUGLAS JR (PA)
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:DOUGLAS
Last Name:TESTERMAN
Suffix:JR
Gender:M
Credentials:PA
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Mailing Address - Street 1:5824 BEE RIDGE RD
Mailing Address - Street 2:#446
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-5065
Mailing Address - Country:US
Mailing Address - Phone:941-400-1901
Mailing Address - Fax:941-379-8219
Practice Address - Street 1:5824 BEE RIDGE RD
Practice Address - Street 2:#446
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-5065
Practice Address - Country:US
Practice Address - Phone:941-400-1901
Practice Address - Fax:941-379-8219
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9102238363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9102238OtherSTATE PA LICENSE
FLPA9102238OtherSTATE PA LICENSE