Provider Demographics
NPI:1982606117
Name:MINSAL, GERARDO (MD)
Entity type:Individual
Prefix:DR
First Name:GERARDO
Middle Name:
Last Name:MINSAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GERARDO
Other - Middle Name:JOSE
Other - Last Name:MINSAL BALLESTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5200 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-2706
Mailing Address - Country:US
Mailing Address - Phone:305-751-8626
Mailing Address - Fax:
Practice Address - Street 1:4300 ALTON RD
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2800
Practice Address - Country:US
Practice Address - Phone:305-674-2430
Practice Address - Fax:305-674-2413
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME64508207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3790703-00Medicaid
FLE70852Medicare UPIN
FL27213WMedicare PIN