Provider Demographics
NPI:1316900129
Name:GERTNER, HAROLD R JR (MD)
Entity type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:R
Last Name:GERTNER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1121 NW 64TH TERRACE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605
Mailing Address - Country:US
Mailing Address - Phone:352-331-6777
Mailing Address - Fax:352-331-8899
Practice Address - Street 1:1121 NW 64TH TERRACE
Practice Address - Street 2:SUITE A
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605
Practice Address - Country:US
Practice Address - Phone:352-331-6777
Practice Address - Fax:352-331-8899
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0013253208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01237OtherBLUE CROSS BLUE SHIELD
FL01237OtherBLUE CROSS BLUE SHIELD
FL01237YMedicare ID - Type Unspecified