Individual
JASON L. GERBOC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1210 WATERMAN WAY, TAVARES, FL 32778-5229
(352) 343-2364
(352) 343-0548
Mailing address
1210 WATERMAN WAY, TAVARES, FL 32778-5229
(352) 343-2364
(352) 343-0548
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
OS012897
PA
208800000X
Urology Physician
Primary
OS12668
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101228162 0002
—
PA
05
—
1012281620001
—
PA
01
—
1724365
HIGHMARK BLUE SHIELD
PA
01
—
2392880000
KEYSTONE IBC
PA
01
—
8460478
AETNA HMO
PA
01
—
P00226465
RAILROAD MEDICARE
PA
01
—
P01092454
RAILROAD MEDICARE
PA
Enumeration date
08/18/2006
Last updated
08/20/2014
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