Provider Demographics
NPI:1053396150
Name:KERI, JONETTE ELIZABETH (MD, PH D)
Entity type:Individual
Prefix:DR
First Name:JONETTE
Middle Name:ELIZABETH
Last Name:KERI
Suffix:
Gender:F
Credentials:MD, PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1600 NW 10TH AVE
Mailing Address - Street 2:ROOM 2023A (R-250)
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1015
Mailing Address - Country:US
Mailing Address - Phone:305-243-4472
Mailing Address - Fax:305-243-6191
Practice Address - Street 1:1600 NW 10TH AVE
Practice Address - Street 2:ROOM 2023A (R-250)
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1015
Practice Address - Country:US
Practice Address - Phone:305-243-4472
Practice Address - Fax:305-243-6191
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78553207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2594242-00Medicaid
FL2594242-00Medicaid
FLH19074Medicare UPIN