Provider Demographics
NPI:1962547109
Name:LERNER, JEFFREY CARL (DPM)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:CARL
Last Name:LERNER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10115 W FOREST HILL BLVD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-3105
Mailing Address - Country:US
Mailing Address - Phone:561-641-7884
Mailing Address - Fax:561-641-0440
Practice Address - Street 1:10115 W FOREST HILL BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-3105
Practice Address - Country:US
Practice Address - Phone:561-641-7884
Practice Address - Fax:561-641-0440
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPO1852213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDG1880OtherRAILROAD MEDICARE
FL87973OtherBCBS
FL87973OtherBCBS
FLT91414Medicare UPIN